癌痛患者自控静脉镇痛技术临床实践规范的四川专家共识

Sichuan Expert Consensus on Patient-Controlled Intravenous Analgesia Technology for Cancer Pain Patients

患者自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)是实现癌痛患者个体化治疗的常用形式,适用于口服用药困难、口服大剂量药物疼痛控制不佳或终末期癌痛患者,也是难治性癌痛维持治疗及癌性爆发痛的主要处置方式。PCIA首选强阿片类药物,根据患者实际情况可选择联合使用辅助治疗药物。PCIA具有起效快、血药浓度稳定、无镇痛盲区、按需给药等特点。为更好地规范PCIA技术在四川省癌痛管理中的应用,四川省抗癌协会肿瘤疼痛学专家委员会在广泛借鉴国内外指南、规范,并结合四川省癌痛多学科治疗及全病程管理推广应用技术经验的基础上制定了本专家共识,以期为临床实践提供指导建议。

Patient-controlled intravenous analgesia(PCIA)is a commonly used individualized treatment for patients with cancer pain,which is suitable for patients with difficulty in oral medication,poor pain control by taking large doses of oral drugs or the pain in terminal stage cancer,and it is also the main treatment of intractable cancer pain and breakthrough cancer pain.Strong opioids are preferred in PCIA,and adjuvant therapy drugs can be selected according to the actual situation of patients.PCIA is characterized by rapid onset,stable blood concentration,no analgesic blind area,and on-demand administration.In order to better standardize the application of PCIA technology in cancer pain management in Sichuan Province,the Cancer Pain Expert Committee of Sichuan Anti-cancer Association has formulated this expert consensus on the basis of widely drawing lessons from domestic and foreign guidelines and norms,with the experience of multidisciplinary treatment and full-course management of cancer pain in Sichuan Province,with a view to providing guidance and suggestions for clinical practice.