阿片类药物用于疼痛治疗

　　阿片类药物是常用的镇痛药物，这篇文献根据已有文献对成年人使用阿片类药物治疗疼痛进行了系统综述，现分享其摘要，有兴趣的可以下载全文了解详细信息。

　　成年人使用阿片类药物治疗疼痛

　　鉴于阿片类药物在疼痛治疗中无处不在，这类药物也代表了临床疼痛医学中最不为人知的组成部分，这是一个有趣的悖论。多年来，人们对阿片类药物的作用机制有着浓厚的兴趣，但这并没有导致令人信服的临床数据的相应增加。这篇综述主要侧重于围绕慢性疼痛中长期使用阿片类药物的证据，但是对这项研究的讨论常常与非常不同的数据混为一谈，这些数据涉及急性疼痛和癌症相关疼痛，其疗效证据更为明确。因此，有必要澄清阿片类药物治疗的循证指征。几乎没有证据表明阿片类药物能改善慢性疼痛患者3个月以上的功能或生活质量。在所有这三类患者群体中，耐受性、依赖性、痛觉过敏和戒断是影响患者体验的关键因素，特别是长期使用阿片类药物的决定。这是一条共同的线索，将所有这些领域的阿片类药物文献联系在一起，证明了基础科学文献对这些现象的兴趣。迫切需要解决阿片类药物使用的这些负面后果，以便最大限度地发挥类阿片类药物所能提供的治疗效果。

　　Painmanagement with opioids in adults

　　Giventhe ubiquitous nature of opioids in the treatment of pain, it is an interestingparadox that this class of medications also represents one of the leastunderstood components of clinical pain medicine. For many years, there has beenintense interest in the mechanisms of opioid activity, but this has notresulted in a corresponding increase in convincing clinical data. This reviewfocuses primarily on the evidence surrounding the long-term use of opioids inchronic pain, but discussions of this research are often conflated with thevery different data governing acute and cancer-related pain, where evidence ofefficacy is clearer. It is therefore important to clarify the evidence-basedindications for opioid therapy. There remains very little evidence that opioidsimprove function or quality of life beyond 3 months in people with chronic painconditions. In all three patient populations, the development of tolerance,dependence, hyperalgesia and withdrawal are key phenomena that affect thepatient experience, and in particular the decision to remain on opioids in thelong term. This is a common thread that connects the opioid literature in allof these spheres, and justifies the burgeoning interest in these phenomena inthe basic science literature. There is an urgent need to address these negativeconsequences of opioid use, in order to maximize the therapeutic benefit thatopioids can offer.