著者

加藤 佳子 山川 真由美 長岡 由姫 加藤 滉

出版者

Japan Society of Pain Clinicians

雑誌

日本ペインクリニック学会誌 (ISSN:13404903)

巻号頁・発行日

vol.12, no.1, pp.25-28, 2005-01-25 (Released:2009-12-21)

参考文献数

7

被引用文献数

3

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1988年から2004年3月までの16年間に,「WHO方式がん疼痛治療法」に準じて100人以上の非がん性疼痛患者にモルヒネによる疼痛治療を行った. そのうち1年以上モルヒネの内服治療を継続した患者は16人, 原病の進行によって死亡した2人を除いた14人は現在も内服を継続中である. 最長例は骨粗鬆症・圧迫骨折の疼痛を治療中の全身性エリテマトーデス (SLE) 患者で13年である. モルヒネの服用量は, 痛みが強くなって増量しても, 痛みが軽減するとすべての患者で必ず減量できた. また痛みの変動がなければモルヒネ必要量は長期間変化しなかった, 病状の変化に対応して服薬指導を繰り返し,「痛みの自己管理」へ導くことによって, モルヒネによる治療は長期間にわたって確実で安全な除痛法となる.

著者

加藤 佳子 山川 真由美 長岡 由姫 加藤 滉

出版者

日本疼痛学会

雑誌

PAIN RESEARCH (ISSN:09158588)

巻号頁・発行日

vol.18, no.2, pp.71-75, 2003-08-31 (Released:2014-04-02)

参考文献数

4

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We reported four patients who received the treatment for severe pain with normal saline and/or distilled water injections. They suffered from various kinds of severe pain. The diagnoses were, a chest pain from bone metastases of terminal liver cancer (Case 1), a low back and leg pain from lumbar spinal canal stenosis (Case 2), a scar pain after thoracic drainage (Case 3) and a postherpetic pain in cervical region (Case 4). All patients received the treatment consisted of nonsteroidal anti-inflammatory drugs (NSAIDs) and pentazocine and/or continuous epidural block, but pain relief was a little and incomplete. While they requested more potent pain relieving measures, but received injections of normal saline and/or distilled water. They recognized that “analgesic” injections had either some effect or no effect, but their physicians thought of the complaints as “psychogenic”one. After consulting to our clinic, we informed them in detail about the treatments with morphine and/or codeine. All 4 patients received our proposal, oral codeine (Case 2, 3) or continuous intravenous/oral morphine (Case 1, 4) started. Pain effectively relieved in all cases with satisfaction. In the treatment of pain, the word, “believe the patient's report of pain”, is the most fundamental principle. When patients complain of pain, they really suffer from pain and want more potent or much doses of analgesic,not normal saline or distilled water ! At that time, physician should “believe the patient's report of pain” and provide reliable pain-relieving therapies.