Tuberculosis and Respiratory Diseases

  • 제62권2호
  • /
  • Pages.140-143
  • /
  • 2007
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

폐암 환자에서 고용량 펜타닐 첩포를 이용한 심한 암통증의 치료 경험

Successful Treatment with High Dose Transdermal Fentanyl Patch for Severe Cancer Pain in a Patient with Lung Cancer

  • 류정선 (인하대학교 의과대학 내과학교실) ;
  • 김수한 (인하대학교 의과대학 내과학교실) ;
  • 엄욱현 (인하대학교 의과대학 내과학교실) ;
  • 조재화 (인하대학교 의과대학 내과학교실) ;
  • 곽승민 (인하대학교 의과대학 내과학교실) ;
  • 이홍렬 (인하대학교 의과대학 내과학교실)
  • Ryu, Jeong-Seon (Department of Internal Medicine, College of Medicine, Inha University) ;
  • Kim, Soo-Han (Department of Internal Medicine, College of Medicine, Inha University) ;
  • Um, Uk-Hyun (Department of Internal Medicine, College of Medicine, Inha University) ;
  • Cho, Jae-Hwa (Department of Internal Medicine, College of Medicine, Inha University) ;
  • Kwak, Seung-Min (Department of Internal Medicine, College of Medicine, Inha University) ;
  • Lee, Hong-Lyeol (Department of Internal Medicine, College of Medicine, Inha University)
  • 투고 : 2006.12.28
  • 심사 : 2007.02.08
  • 발행 : 2007.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

심한 암통증을 호소하는 폐암 환자에서 고용량 펜타닐 첩포($600{\mu}g/hr$)를 이용하여 통증의 완화를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.

A 60-year-old man was diagnosed with locally advanced non-small cell lung cancer. He refused treatment with a curative aim and was treated conservatively. Pain had developed on his shoulder and chest wall, which became worse as the cancer progressed. Although his pain initially appeared to be relieved with weak opioids and analgesics, it became more severe Strong opioids (transdermal fentanly patch and oxycodone), antidepressant or epidural block were introduced, However, the background pain became more intense and reached up to 8~9/10 on the visual analog scale (VAS). The dose of the transdermal fentanl patch was gradually increased to $600{\mu}g/hr$, which resulted in a dramatic improvement in his pain (9/10 of VAS) to 3/10 for most of the time. We described the successful experience with a high dose transdermal fentanyl patch for cancer pain relief, which might be an alternative option for cancer patients suffering from severe pain.

키워드

참고문헌

  1. World Health Organization. The World Health Report 1996: fighting disease, fostering development, executive summary. Geneva: World Health Organization; 1996. Avail from: URL: http://www.who.int/whr/1996/en/
  2. Cherny N. New strategies in opioid therapy for cancer pain. J Oncol Manag 2000;9:8-15
  3. Muijsers RB, Wagstaff AJ. Transdermal fentanyl: an updated review of its pharmacological properties and therapeutic efficacy in chronic cancer pain control. Drugs 2001;61:2289-307 https://doi.org/10.2165/00003495-200161150-00014
  4. Allan L, Hays H, Jensen NH, de Waroux BL, Bolt M, Donald R, et al. Randomised crossover trial of transdermal fentanyl and sustained release oral morphine for treating chronic non-cancer pain. BMJ 2001;322:1154-8 https://doi.org/10.1136/bmj.322.7295.1154
  5. Skaer TL. Management of pain in the cancer patient. Clin Ther 1993;15:638-49
  6. Ahles TA, Ruckdeschel JC, Blanchard EB. Cancer-related pain-II: assessment with visual analogue scales. J Psychosom Res 1984;28:121-4 https://doi.org/10.1016/0022-3999(84)90004-7
  7. Grond S, Zech D, Diefenbach C, Radbruch L, Lehmann KA. Assessment of cancer pain: a prospective evaluation in 2266 cancer patients referred to a pain service. Pain 1996;64:107-14 https://doi.org/10.1016/0304-3959(95)00076-3
  8. Brescia FJ, Adler D, Gray G, Ryan MA, Cimino J, Mamtani R. Hospitalized advanced cancer patients: a profile. J Pain Symptom Manage 1990;5:221-7 https://doi.org/10.1016/0885-3924(90)90015-C
  9. Korean Society for Hospice and Palliative Care, Korean Cancer Study Group. Cancer pain relief guideline. Seoul: Korean society for hospice and palliative care, Korean cancer study group; 2001
  10. National Comprehensive Cancer Network. NCCN clinical pratice guideline: adult cancer pain. 2006. Avail from: URL: http://www.nccn.org/professionals/physician_gls/PDF/pain.pdf
  11. Potter J, Higginson IJ. Pain experienced by lung cancer patients: a review of prevalence, causes and pathophysiology. Lung Cancer 2004;43:247-57 https://doi.org/10.1016/j.lungcan.2003.08.030
  12. Radbruch L, Sabatowski R, Petzke F, Brunsch- Radbruch A, Grond S, Lehmann KA. Transdermal fentanyl for the management of cancer pain: a survey of 1005 patients. Palliat Med 2001;15:309-21 https://doi.org/10.1191/026921601678320296
  13. Menahem S, Shvartzman P. High-dose fentanyl patch for cancer pain. J Am Board Fam Pract 2004;17: 388-90 https://doi.org/10.3122/jabfm.17.5.388
  14. Portenoy RK, Lesage P. Management of cancer pain. Lancet 1999 353:1695-700 https://doi.org/10.1016/S0140-6736(99)01310-0
  15. Ripamonti C, Zecca E, De Conno F. Pharmacological treatment of cancer pain: alternative routes of opioid administration. Tumori 1998;84:289-300 https://doi.org/10.1177/030089169808400302