（课件）末期病人疼痛处置概论.pptVIP

末期病人疼痛處置概論 Woei-Yau Kao, MD, PhD Tri-Service General Hospital National Defense Medical Center Outline General guidelines (Pharmacology, titration) Transdermal fentanyl patch Opioid tolerance, Hyperanalgesia, Withdrawal symptoms Opioid rotation Addition of a second opioid Combination of opioid agonists and antagonists Renal/hepatic failure, old man Summary 疼痛用藥原則 經口服藥 按時用藥 階梯步驟 個人化原則 加入輔助用藥 注意細節 最大效果與最小副作用 癌症疼痛的評估-2 一般使用VAS (visual analog score) 方式，讓病人挑選一個圖案代表此時疼痛情形，做為評估治療的依據。 Choice of Opioid Analgesic Recommendation from AHCPR Cancer Pain Guidelines Panel: “The simplest dosage schedules a