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首页> 外文期刊>The American journal of hospice and palliative care >Intravenous morphine can avoid distressing constipation associated with oral morphine: a retrospective analysis of our experience in 11 patients in the palliative care in-patient unit.
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Intravenous morphine can avoid distressing constipation associated with oral morphine: a retrospective analysis of our experience in 11 patients in the palliative care in-patient unit.

机译：静脉使用吗啡可以避免与口服吗啡有关的令人困扰的便秘：对我们在姑息治疗住院单元中11例患者的经验进行的回顾性分析。

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摘要

Morphine is the preferred strong opioid analgesic. Most of the adverse effects, such as daytime drowsiness, dizziness, mental clouding, and effects on cognitive and psychomotor function or nausea and vomiting, usually resolve with time. The main continuing adverse effect of morphine is constipation, and prophylactic use of laxative is almost always required. We are presenting retrospective data of 11 patients admitted in our palliative care unit over the past 5 months for new (not yet received any opioid analgesic in any form) and severe cancer pain management. It was found that none of the patients was having constipation with intravenous morphine. This finding can be explained on the basis of differences in pharmacologic profiles, in affinity to opioid receptor, and a higher exposure of opioid-binding receptor in the GI tract after oral administration of morphine compared with intravenous morphine. This explanation was further affirmed as constipation and need for laxative was reported by 7 of the 11patients when they were given the equi-analgesic oral doses of morphine. Thus, the route of administration seems to be responsible for the above finding; hence, further evaluation with prospective observation and data collection is being planned to look for external validity in a larger population catered by our palliative care unit.
机译：吗啡是首选的强阿片类镇痛药。大多数不良反应（例如白天嗜睡，头昏眼花，精神阴郁以及对认知和心理运动功能或恶心和呕吐的影响）通常会随着时间而消失。吗啡的主要持续不良作用是便秘，几乎总是需要预防性使用泻药。我们将提供过去5个月来我们姑息治疗室收治的11例患者的回顾性数据，这些患者因新的（尚未接受任何形式的阿片类镇痛药）和严重的癌症疼痛治疗而入院。发现没有患者患有静脉内吗啡便秘。可以根据与口服吗啡相比口服吗啡后药理学特征，对阿片受体的亲和力以及在胃肠道中阿片结合受体的更高暴露来解释这一发现。 11名患者中有7名接受了吗啡等镇痛口服剂量时，便进一步证实了这种解释为便秘，并报告需要通便。因此，管理途径似乎是造成上述发现的原因。因此，我们计划通过前瞻性观察和数据收集进行进一步评估，以寻找我们姑息治疗部门迎合的更大人群的外部有效性。

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