作者: C. Mann
DOI:
关键词: Patient-controlled analgesia 、 Anesthesia 、 Opioid 、 Pain ladder 、 Fentanyl 、 Cancer pain 、 Sufentanil 、 Surgery 、 Medicine 、 Morphine 、 Ketamine
摘要: Patient-controlled analgesia (PCA) is indicated for patients experiencing moderate to severe nociceptive cancer pain unrelieved by strong oral or transdermal opioids. This appropriate in two situations: 1) the impossibility of administration, and 2) inadequate control breakthrough pain. Intravenous morphine remains most frequently used opioid PCA devices. Background infusion provides effective management baseline pain; its dosage calculated according daily amount previously taken patient. The bolus dose (ranging between 1/24 1/10 amount) as treat In case renal insufficiency, fentanyl sufentanil can be used. If patient experiences refractory tolerance, it possible associate with low doses ketamine. Lastly, difficult cases, spinal route (epidural intrathecal) may an alternative terms improving quality life end-of-life patients.