Pain control控制疼痛.pptVIP

The following principle s apply when using morphine or similar strong opioids for pain control. 当使用吗啡或类似的强阿片类药物进行镇痛时应遵循以下原则。 Oral administration is the route of choice. 口服是常规的选择。 Regular administration is mandatory, at a frequency depending on the duration of action of the drug.规律用药是强制性的，根据该药物的药效持续时间制定服用的频率。 There is effectively no ‘ceiling’ to the dose of morphine given (unlike the weak opiods). When rapidly escalating doses are required, complete reassessment of the pain is essential. 不像弱阿片类药物，吗啡没有天花板效应。当需要大剂量增加药量时，需要对疼痛进行完全的评估。 Useful routes of administration of opioids. Oral：immediate-release morphine preparations are available as liquid or tablets and should be used initially to establish the patient’s individual analgesic requirement. 实用的阿片类药物给药方式 口服：即释吗啡可以通过片剂或水剂的方式直接满足患者镇痛的需求。 Because the drug is given at 4-hourly intervals, the dose may be increased on a daily or even twice-daily basis to achieve rapid pain control. Once the pain is controlled, switch to a more convenient modified-release preparation. Use of modified-release morphine preparations has simplified treatment schedules, improved patient compliance and reduced patient and family anxiety. They are used most safely when pain has been controlled by immediate-release preparations. Experienced clinicians may choose to start with modified-release preparations in selected patients. 因为是每隔 4 小时给药的，可通过每天或隔天增药的方式实现快速疼痛控制。一旦疼痛得到控制，转换成一种较便于调控的剂型。吗啡控释制剂的使用已简化处理日程安排， 提高了病人的依从性和减少病人和家庭的焦虑。当疼痛已经被即释剂型控制时，他们的使用将会是最安全的。有经验的临床医生可以一开始就对选定的患者使用控释制剂。 They are available as 12-hourly and 24-hourly preparations, as suspension or tablets, and in a wide range of doses. Parenteral - this may be necessary when patients cannot take their drugs by mouth (e.g. dysphagia or nausea). Morphine and diamorphine have similar efficacies but in countries where it is available, diamorphine is preferred for parenteral administration because it is more soluble and can be given in a smaller volume. 他们可分为 12 小时和 24 小时剂型，作为悬浮液或片剂，或其它广泛的剂