美沙酮在成人慢性非癌疼痛。
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Haroutiunian年代,McNicol ED, Lipman AG)
美沙酮在成人慢性非癌疼痛。
Cochrane数据库系统启2012年11月14日,11:CD008025。cd008025.pub2 doi: 10.1002/14651858.。
- PubMed ID
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23152251 (在PubMed]
- 文摘
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背景:美沙酮属于一个类被称为阿片类药物的镇痛药,这被认为是治疗的基石是严重危及生命的疾病痛苦;然而,他们用在慢性非癌疼痛(摘要)是有争议的。美沙酮有许多特点,区分它与其他阿片类药物,这表明它可能有不同的疗效和安全性。目的:评估镇痛的有效性和安全性临床实务的美沙酮治疗。必威国际app搜索方法:我们确定了两个随机对照试验(相关的)和非随机性的研究美沙酮用于慢性疼痛通过搜索Cochrane中央登记的对照试验(中央)Cochrane图书馆2011年问题11,MEDLINE(1950年至2011年11月),和EMBASE(1980年至2011年11月),连同参考列表检索论文和评论。选择标准:包括与疼痛相关的评估主要或次要的结果。Quasi-randomized研究中,军团和病例对照试验也考虑包容,因为我们怀疑美沙酮在临床实务的有益和有害的影响可能没有充分解决相关的。数据收集和分析:两个评论作者独立提取数据,评估疗效和副反应的风险的偏见。主要结果:包括两个相关的和一个非随机研究中,共有181名参与者。这两个相关的交叉研究,其中包括19个参与者与多样的神经性疼痛综合症,postherpetic神经痛的其他76名参与者。 Study phases were 20 days and approximately eight weeks, respectively. The non-randomized study retrospectively evaluated 86 outpatients over an average of 8.8 +/- 6.3 months.One RCT reported average pain intensity and pain relief, and found statistically significant improvements versus placebo for both outcomes, with 10 mg and 20 mg daily doses of methadone. The second RCT reported differences in pain reduction between methadone and morphine and found morphine to be statistically superior. The non-randomized study found that in patients initially prescribed methadone it was effective in fewer participants than in those initially prescribed other long-acting opioids (28% versus 42%, 33% and 50% for morphine, oxycodone and transdermal fentanyl, respectively).One RCT compared incidences for several individual adverse events, but found a difference between methadone and placebo for only one event, dizziness (P = 0.041). AUTHORS' CONCLUSIONS: The three studies provide very limited evidence of the efficacy of methadone for CNCP, and there were too few data for pooled analysis of efficacy or harm, or to have confidence in the results of the individual studies. No conclusions can be made regarding differences in efficacy or safety between methadone and placebo, other opioids, or other treatments.
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