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.1988v34n2/3.3157Keywords:
Buprenorphine, Cancer PainAbstract
In order to evaluate control of câncer pain under sublingual Buprenorphine (Temgesic), 32 patients were evaluated. The difficulties in measurement of clinical pain intensity are discussed. Three scales were used in the criteria for judging pain intensity. The most common side effects were: nausea in 12.5%, vomiting in 21.8%, dizziness in 6.2%, and drowsiness in 15.6%. Of the 7 patients with vomits only 3 did not have the symptom before starting on Temgesic. Therewasnocaseofrespiratorydepression. Drowsiness, more common in patients over 70 years, beneficted from smaíler doses (10 micrograms) at 6 hour intervals instead of full doses of 20 micrograms at 12 hour intervals. The analgesic effect was enhanced by aging; it was excellent in metastatic bone disease, very good in pelvic tumorsand less than satisfàctory in gastric cancer. The sublingual route was appreciated by all patients, compared with previous parenteral use of analgesic drugs.
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References
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
