Emine ÖZYUVACI, Aysel ALTAN, Şule VATANSEVER, Abdulkadir İSKENDER

Kanser ağrısı ve transdermal fentanil kullanımı

Kanser tanısı almış ve çeşitli nedenlere bağlı ağrısı bulunan 262 olguda, kullandığımız transdermal fentanilin (TDF) etki ve yan etkilerini retrospektif olarak değerlendirdik. TDF 1-360 gün (ort 64 gün) süreyle uygulandı. Ağrı şiddetinin değerlendirilmesinde Visuel Analog Skala (VAS) ile birlikte, verilen analjezik cevabı; çok iyi, iyi, yeterli ve yetersiz olarak değerlendirildi. TDF her 3 günde bir değiştirildi. Doz arttırma, VAS 4'ün üzerinde ise ve hastalıkta ilerleme kaydediliyorsa yapıldı. Kullanılan doz, 25-300 $mu$g saat-1 (ort 35.6 u$mu$g saat-1) olarak bulundu. Olgu izlemeleri süresince 188 olguda (%71) çok iyi cevap alındı. 92 (%35) olguda yan etkiler görüldü. Bulantı, kabızlık ve solunum sıkıntısı en sık görülen yan etkilerdi. Sonuç olarak; transdermal fentanil, kanser ağrısının tedavisinde yaklaşım ilkelerinin 3. basamağı için alternatif bir ilaçtır, diğer opioid ve adjuvan ilaçlar ile kombine edilerek kullanıldığında etkili ve güvenli bir analjezi sağlamaktadır.

Anahtar Kelimeler:

Ağrı ölçümü, İlaç uygulama, deri, Analjezi, Fentanil, Geriyedönük çalışma

The use of transdermal fentanyl for cancer pain

In this study, the utility and the side effect profile of transdermal fentanyl (TDF) patch treatment was asssessed in 262 consecutive cancer patients with pain due to diverse causes. The pain was assessed using the visual analog scale (VAS) and analgesic response as excellent, good, fair and inadequate. TDF patches were changed every third day. Doses were incremented if the pain response was over 4 and disease progression was seen. The doses used ranged from 25 to 300 $mu$g hr-1 with a mean of 35.6 $mu$g hr-1. The response was excellent in 188 cases (71%). Number of patients with side effects was 92 (35%). Most frequent side effects were nausea, constipation and respiratory distress. It was concluded that this modality of treatment was an alternative to 3rd stage treatment of cancer pain. TDF are safe and effective when combined with other opioid and adjuvant treatments.

Keywords:

Pain Measurement, Administration, Cutaneous, Analgesia, Fentanyl, Retrospective Studies,

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