芬太尼离子渗透经皮给药系统在术后疼痛治疗中的应用.pdfVIP

芬太尼离子渗透经皮给药系统在术后疼痛 治疗中的应用 喻洁 黄宇光 [摘要] 背景 盐酸芬太尼离子渗透经皮给药系统(fentanylHcliontophoretictransdermalsystem，fentanyl，ITS)是通过电 离子渗透技术经体表的微弱电场由皮肤给予芬太尼，产生镇痛作用的给药装置。已在美国和欧洲批准上市，用于治疗中到重度 的手术后疼痛。 目的 主要回顾了在欧美针对该给药系统所进行的一系列临床试验。内容 安慰剂对照试验和阳性药物平 行对照试验均证实，以离子渗透技术经皮给予芬太尼对多种手术后疼痛有良好的治疗作用。该给药系统具有与标准的吗啡患者 自控镇痛 （patient-controlledanalgesia，PCA）相似的有效性和安全性。趋向 ITS具有无创，有效，安全，简单，易于为患者接受 等优点，为临床提供了一种全新的PCA方式。 患者自控镇痛；芬太尼；术后镇痛；经皮给药 Fentanyliontophoretictransdermalsysteminpostoperativepainmanagement YUJieHUANGYu-guang Department ofAnesthesiologyPekingUnionMedicalSchoolHospital,Beijing100073,China Background Thefentanylhydrochlorideiontophoretictransdermalsystem(fentanylITS)isaneedle-free,self containeddrug-deliverysystemthatusesiontophoretictechnologytodeliverfentanylthroughtheskinbyapplicationofalow-intensity electricalfield.IthasbeenapprovedintheUSAandEuropeforthemanagementofacute,moderate-to-severepostoperativepain. Objective ThisreviewfocusonseveralclinicaltrailsoffentanylITS,whichhavebeencarriedoutinAmericaandEurope. Content Inthreephase3placebo-controlledtrials,fentanylITSwasshowntobesuperiortoplaceboforthetreatmentof postoperativepainfollowingmajorabdominal,orthopedicandthoracicsurgery.Theresultsofseveralactive-comparatorphase3trial demonstratedcomparablesafetyandefficacywithastandardmorphineintravenouspatient-controlledanalgesia (Ⅳ-PCA)dosing regimen,withoutsignificantdifferenceinthesideeffectprofile. Trend FentanylITSisanovelpatient-controlledanalgesia(PCA) systemallowingpatientstoself-administerpre-programmeddosesoffentanyl.Itrepresentsasafe,easytouse,non-invasiveand convenientalternativetocurrentacutepostoperativepainmanagementmodalities. Analgesia,Patient-controlled; Fentanyl; Pain,Postoperative; Iontophoresis,Transdermal 10.3760/cma.j.issn.1673-4378.2011.10.029 100073，北京协和医学院附属北京协和医院麻醉科 万方数据 627 万方数据 628