モルヒネ持続静脈内投与による肺癌終末期の疼痛管理について

DOI 被引用文献1件 参考文献7件
  • 加藤 佳子
    Department of Anesthesia and Resuscitation, Yamagata University School of Medicine
  • 加藤 滉
    Department of Anesthesia Okitama Public General Hospital
  • 山川 真由美
    Department of Anesthesia and Resuscitation, Yamagata University School of Medicine
  • 小田 真也
    Department of Anesthesia and Resuscitation, Yamagata University School of Medicine

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  • Management of Pain in Terminal Lung Cancer Patients

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Purpose of Study: The role of continuous intravenous infusion of morphine (CIVI-Morphine) was evaluated in terminal lung cancer patients with pain.<br>Methods: In the 10-year period from 1988 to 1998, 33 patients with progressive lung cancer were given CIVI-Morphine until their deaths. Clinical staging, symptoms, duration of CIVI-Morphine and the daily amount of morphine were investigated.<br>Results: Of these 33 patients, 6 (18%) were in Stage III (regional metastases), and 26 (79%) in Stage IV (remote metastases). Besides pain relief, alleviation of dyspnea was also requested in 11 Cases (33%). As the primary symptom of lung cancer, pain (14 cases, 42%) followed coughing (20 cases, 61%) in frequency of occurrence. Twenty-six patients (79%) were found to have metastases to bone at the time of referral to our Pain Clinic. The duration of CIVI-Morphine ranged from 1 to 161 days (mean 22 days, median 18 days). Forty-five percent of the patients died within two weeks of CIVI-Morphine and 90% within one month. Daily amounts of morphine given were 10 to 1, 500mg/day (mean 136mg/day, median 80mg/day). For the control of pain, 45% of patients required less than 50mg/day, and 80% of patients required less than 200mg/day.<br>Conclusion: Progression of lung cancer and advent of pain are rapid. It is imperative to start pain relief therapy in the early stages. Relief of pain is best accomplished by early institution of CIVI-Morphine, especially in patients for whom difficulty in breathing and swallowing develops.

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