高用量モルヒネ持続注射からフェンタニルパッチへの切り換えにより良好な疼痛コントロールが得られた末期食道がんの1例

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In this paper, we report the case of a patient with terminal esophagus cancer whose cancer pain was well controlled by transdermal fentanyl. The subject was a 68-year-old man who was diagnosed with esophagus cancer in February 2005. Chemotherapy and radiotherapy were started in June but were stopped due to adverse effects and he was hospitalized for the purposes of esophagus extension and pain control. The pain was controlled by sustained morphine injections at 400 mg/day and there were no adverse effects. He underwent percutaneous endoscopic gastromy due to difficulty in oral intake and was then switched to transdermal fentanyl. Since the morphine been given at a high dose, we made the switch to transdermal fentanyl over two weeks. The cancer pain could be controlled with transdermal fentanyl at 50 mg/3 days and betamethasone syrup at 1 mg/day. Our findings indicate the necessity of pharmacist intervention in switching from high dose morphine to transdermal fentanyl.
2007-09-10