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Intrathecal ziconotide for refractory pain.

机译:鞘内注射齐考诺肽治疗顽固性疼痛。

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For cancer and AIDS patients, 10 - 30% of pain is refractory to strong opioids, requiring intraspinal administration for pain management. Ziconotide is a selective N-type calcium channel blocker, which inhibits neurotransmitter release, and following intrathecal administration will affect primary nociceptive afferents. In 108 patients with previously unmanaged refractory pain despite the use of systemic or intrathecal opioids, in the initial titration phase, the mean Visual Analogue Scale of Pain Intensity scores improved more in the ziconotide group (53%) than the placebo group (18%). Serious adverse effects were more common in the ziconotide group (31%) than placebo group (10%) in the initial titration phase. In the 48 patients receiving ziconotide, who proceeded to the maintenance phase, the benefit of ziconotide was continued. Until a new approach with a better effectiveness/adverse effects profile than ziconotide for refractory pain emerges, further optimisation of ziconotide for use in the treatment of refractory pain should be undertaken.
机译:对于癌症和艾滋病患者,强烈的阿片类药物难以缓解10%至30%的疼痛,需要通过椎管内给药来进行疼痛管理。 Ziconotide是一种选择性的N型钙通道阻滞剂,可抑制神经递质的释放,鞘内给药后会影响原发性伤害感受传入。在108名既往使用全身或鞘内阿片类药物但仍未得到控制的难治性疼痛患者中,在初始滴定阶段,齐考诺肽组的平均视觉模拟疼痛强度评分评分(53%)比安慰剂组(18%)改善了更多。在初始滴定阶段,齐考诺肽组(31%)的严重不良反应比安慰剂组(10%)更为常见。在进入维持期的接受齐考诺肽治疗的48例患者中,齐考诺肽的获益仍在继续。直到出现一种新药,其效用/不良反应特征优于ziconotide才能治疗顽固性疼痛,应进一步优化ziconotide用于治疗顽固性疼痛。

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