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DOI: 10.1055/s-2003-38651
© Georg Thieme Verlag Stuttgart · New York
Fentanyl-TTS bei Arthrose bedingten Schmerzen
Fentanyl-TTS in the Treatment of Pain Caused by ArthrosisPublication History
Publication Date:
15 April 2003 (online)
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Zusammenfassung
Studienziel: Die Wirksamkeit und Verträglichkeit der Schmerzbehandlung mit Fentanyl-TTS (Durogesic®) bei Arthrose bedingten Schmerzen sollte untersucht werden. Methode: Bei Patienten mit starken, durch eine Kox- und/oder Gonarthrose bedingten Schmerzen wurde die Behandlung mit Fentanyl-TTS neu begonnen und prospektiv über 30 Tage dokumentiert. Die Schmerzen wurden durch den Patienten mittels einer 11-stufigen numerischen Analogskala und vom Arzt mit 5 an den Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) angelehnten Fragen (5-stufige Skala) beurteilt. Ergebnisse: Es wurden 243 Patienten (166 Frauen, 77 Männer) mit einem mittleren Alter von 67 Jahren (Bereich 28 - 94) behandelt. Sowohl Ruhe- als auch Bewegungsschmerz nahmen in der Patientenbeurteilung signifikant von 6,4 ± 2,1 auf 2,9 ± 2,0 bzw. von 8,1 ± 1,5 auf 4,2 ± 2,1 ab (jeweils p < 0,001). Der Summenscore für die 5 Fragen der differenzierten Schmerzbeurteilung durch den Arzt nahm von 18,8 ± 3,2 auf 11,2 ± 4,2 ab (p < 0,001). Eine signifikante Schmerzabnahme fand sich auch für alle 5 Einzelfragen. Am Beobachtungsende betrug der Anteil der schmerz- bzw. beeinträchtigungsfreien Patienten in Abhängigkeit von der Situation 5 % (Treppensteigen), 14 % (Gehen), 26 % (Stehen), 33 % (Liegen/Sitzen) und 44 % (Schlafen). Die häufigsten unerwünschten Ereignisse waren Übelkeit, Erbrechen, Obstipation und Schwindel. Die Behandlung mit Fentanyl-TTS wurde in der Regel gut vertragen. Schlussfolgerung: Starke, durch Arthrose bedingte Schmerzen können mit Fentanyl-TTS gut und mit einem günstigen Nebenwirkungsprofil behandelt werden.
Abstract
Aim: Efficacy and tolerability of analgesic treatment with fentanyl-TTS (Durogesic®) for pain caused by arthrosis was investigated. Method: Treatment with fentanyl-TTS was started for the first time in patients with severe pain caused by coxarthrosis and/or gonarthrosis and was prospectively documented for 30 days. Pain was assessed by the patient with an 11-step numerical analogue scale and by the physician with 5 questions (5-step scale) adapted from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: A total of 243 patients (166 women, 77 men) with a mean age of 67 years (range 28 - 94) was treated. In the patient's rating, pain at rest as well as in motion decreased significantly from 6.4 ± 2.1 to 2.9 ± 2.0 and from 8.1 ± 1.5 to 4.2 ± 21, respectively (p < 0.001 for both comparisons). The sum score for the 5 questions with a detailed pain assessment by the physician decreased from 18.8 ± 3.2 to 11.2 ± 42 (p < 0.001). A significant pain reduction was also observed for each of the 5 single questions. At the end of observation the proportions of patients with no pain or impairment under different conditions were 5 % (climbing stairs), 14 % (walking), 26 % (standing), 33 % (lying/sitting), and 44 % (sleeping). The most common adverse events were nausea, vomiting, obstipation, and dizziness. Treatment with fentanyl-TTS was usually well-tolerated. Conclusion: Severe pain caused by arthrosis can be well treated with fentanyl-TTS with a favourable safety profile.
Schlüsselwörter
Fentanyl-TTS - Opioide - Schmerzen - Gonarthrose - Koxarthrose
Key words
Fentanyl-TTS - opioids - pain - gonarthrosis - coxarthrosis
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