O uso da Buprenorfina Sublingual (TEMGESIC) no Alívio da Dor em Pacientes com Câncer. Um Estudo em 32 Doentes
DOI:
https://doi.org/10.32635/2176-9745.RBC.1988v34n2/3.3157Palabras clave:
Buprenorfina, Dor no CâncerResumen
Um estudo no controle da dor em doentes com câncer, através da Buprenorfina sublingual (Temgesic), foi realizado em 32 pacientes. Foram discutidos os problemas na avaliação c na exata mensuração da dor, tendo sido usadas três escalas para julgar a sua intensidade. Entre os paraefeitos da droga, os mais comuns foram: náuseas em 12,5%, vômitos em 21,8%, tonturas em 6,2% e sonolência em 15,6%. Dos 7 pacientes que apresentaram vômitos, 4 eram portadores de câncer gástrico ou de metástases hepáticas e tinham aquele sintoma antes de iniciar o tratamento com o Temgesic. A sonolência foi mais freqüente em pacientes idosos, acima de 70 anos, os quais conseguiram diminuição daquele sintoma após reduzirem a dose de 20 microgramas de 12/12 horas para 10 microgramas em intervalos de 6/6 horas. O efeito analgésico foi maior nos idosos; foi excelente nas metástases ósseas, muito bom nos tumores pélvicos e pouco satisfatório nos portadores de câncer gástrico. A aplicação sublingual, comparada com os analgésicos anteriormente aplicados por via parenteral, mereceu maior aprovação dos doentes.
Descargas
Citas
Bellville JW, Forrest JrWA, MillerE, Brown JrB — Influence of age on pain relief from analgesics. JAMA, 1971; 217: 1835-41. DOI: https://doi.org/10.1001/jama.217.13.1835
Bond MR - Dor-Natureza, análisee tratamento. 2ed. Rio de Janeiro, Colina, 1986 p. 181.
Buprenex. Linger Acting Analgesia than Morphine or Meperidine (advertise). Arch Surg, 1986: 121: 225-7.
Buprenex. In: Physicians Desk Reference Book. New Jersey. Medicai Economics Co Inc Cradell, 1987; p. 1408-10.
Buprenorphine ITemgesic) In: British National Fbrmulary. London British Medical Association and Pharmaceutical Society of Great Britain, 1984; p. 165.
Coombs DW, Saunders RL, Gaylor MJ — Relief of continuous chronic pain by intraspinal narcotic infusion via an implantable reservoir. JAMA, 1983; 250: 223-6. DOI: https://doi.org/10.1001/jama.1983.03340170062030
Cousins MJ, Mather LE — Intrathecal and epidural administrations of opioids. Anesthesiology, 1984; 61: 276-310. DOI: https://doi.org/10.1097/00000542-198409000-00008
Coyle N - A model of continuity of care for cancer patients with chronic pain. Med Clin North Am, 1987; 71: 259-90. DOI: https://doi.org/10.1016/S0025-7125(16)30869-0
Daudt RC, Cleeland CS — Theprevalenceand severity of pain in cancer Cancer 1982: 50: 1913-19. DOI: https://doi.org/10.1002/1097-0142(19821101)50:9<1913::AID-CNCR2820500944>3.0.CO;2-R
DeConno F Ripamonti C, Tamburini M, Ventafndda V - Buprenorfina nel dolore da cancro: confronto incrociato con Ia pentazocina. Minerva Med, 1987; 78'
Dini D, FassioT, Gottlieb A, Gini M — Studio controllato sul’efetto analgésico e sulla tolerabilità della buprenorfina, in pazienti da neoplasia. Minerva Med, 1986; 77: 93-104.
Downing JW, Leary WP, White SE - Buprenorphine: a new potent long acting synthetic analgesic. Comparison with morphine. Br J Anaesth, 1977; 49:251-9. DOI: https://doi.org/10.1093/bja/49.3.251
Fletcher RH, Fietcher SW — Clinical research in General Medical Journals N EngI J Med, 1979; 301: 180-3. DOI: https://doi.org/10.1056/NEJM197907263010403
Foley KM, Inturrisi CE — Analgesic drug therapy in cancer pain. Principies and Practice. Med Clin'North Am, 1987, 71: 207-32. DOI: https://doi.org/10.1016/S0025-7125(16)30866-5
Health and Public Policy Committee. American College of Physicians. Drug therapy (br severe chronic pain in terminal illness. Ann Intern Med, 1983; 99: 870-3. DOI: https://doi.org/10.7326/0003-4819-99-6-870
Jensen MP, Karoly P, Braver S — The measurement of clinical pain intensity: a comparison of six methods. Pain, 1986; 27: 117-26. DOI: https://doi.org/10.1016/0304-3959(86)90228-9
Kaiko RF, Wallenstein SL, Bogers AG, Grabinski PY, Houde RW - Narcotic in the elderly. Med Clin North Am, 1982; 66: 1079-89. DOI: https://doi.org/10.1016/S0025-7125(16)31383-9
Leavens ME, HilI CS, Cech DA, Weyland JB, Weston JS - Intrathecal and intraventricular morphine for pain in cancer patients: initial study. J Neurosurg, 1982: 56: 241-5. DOI: https://doi.org/10.3171/jns.1982.56.2.0241
Marks RM, Sacher EJ – Undertreatmento f medical in patients with narcotic analgésica. Ann Intern Med, 1973: 78: 173-81. DOI: https://doi.org/10.7326/0003-4819-78-2-173
Morton DB - Assessment of pain. Vet Rec, 1986: 119: 435. DOI: https://doi.org/10.1136/vr.119.17.435-b
Moses LE - The series of consecutiva cases as a device for assessing outcomes of intervention. (Statistic in practice.) N EngI J Med, 1984: 311 (11): 705-10. DOI: https://doi.org/10.1056/NEJM198409133111104
Nassar MA, McLeavy MA, Knox J — An open study of sublingual buprenorphine in the treatmentofchronic pain inthe elderly. Curr Med ResOpin, 1986:10: 251-5. DOI: https://doi.org/10.1185/03007998609110446
Payne R - Anatomy, physiology and neuropharmacology of cancer pain. Med Clin North Am, 1987; 71: 153-67. DOI: https://doi.org/10.1016/S0025-7125(16)30863-X
Payne R - Role of epidural and intrathecal narcotics and peptides in the management of cancer pain. Med Clin North Am, 1987; 71: 313-27. DOI: https://doi.org/10.1016/S0025-7125(16)30873-2
Penn RD, Paige TA, Gottschalk W, Ivanizovich AD - Câncer pain relief using chronic morphine infusion. J Neurosurg, 1984; 61: 302-6. DOI: https://doi.org/10.3171/jns.1984.61.2.0302
Porter J, Jyck H - Addiction rare in patients with narcotics. N EngI J Med, 1980; 302: 123. DOI: https://doi.org/10.1056/NEJM198001103020221
Price DD, Gruen AV, Miller J - Psychophysical analysis of morphine analgesia. Pain, 1985: 22: 261-9. DOI: https://doi.org/10.1016/0304-3959(85)90026-0
Radvila A, Adier RH, Galeazzi RL, Vorkauf H - The development of a german language (Bernel pain questionaire and its appiication in a situation causing pain. Pain, 1987: 28: 185-95. DOI: https://doi.org/10.1016/0304-3959(87)90115-1
Robie DS — A trial of sublingual buprenorphine in cancer pain. Br J Clin Pharmacol, 1979: 7: 3158-75. DOI: https://doi.org/10.1111/j.1365-2125.1979.tb04706.x
Spiegel P, Gonçalves BMV, Rocha BA — Tratamento da dor com morfina por catéter peridural tunelizado. Experiência clínica. Rev Bras Anest, 1986:36 (4): 312-21.
Sundaresan N, DiGiacinto GV — Antitumor and antinoceptives approaches to control cancer pain. Med Clin North Am, 1987; 71: 329-48. DOI: https://doi.org/10.1016/S0025-7125(16)30874-4
Turk DC, Rudy TE — Towards a comprehensive assessment of chronic pain patients. Behav Res Ther, 1987; 25: 234-49. DOI: https://doi.org/10.1016/0005-7967(87)90002-7
Vanacker B, Vandermeersch E, Tomassen J - Comparison of intramuscular buprenorphine and a buprenorphine naioxane combination in the treatment of postoperative pain. Curr Med Res Opin, 1986; 10: 139-44. DOI: https://doi.org/10.1185/03007998609110432
Zenz M, Schappier-Scheele B, Neuhaus R, Piepenbrock S, Hilfrich D - Long term epidural morphine analgesia in cancer pain. Lancet, 1981; 1:91. 1177-81. DOI: https://doi.org/10.1016/S0140-6736(81)90018-0
