만성 신경병증성 통증 치료를 위한 경피적 펜타닐페취

Abstract

Background: Substantial number of patients with neuropathic pain experience disabling pain and poor quality of life (QOL). Recently, it has been shown that opioid can play significant role in selected patients with neuropathic pain syndromes. Transdermal fentanyl (TDF) is a skin patch that slowly and uniformly delivers fentanyl, a potent synthetic opioid. Purpose of this study was to verify its role in management of moderate to severe chronic neuropathic pain of both peripheral and central types. Materials & Methods: Sixty-six patients with neuropathic pain of central or peripheral type were treated with TDF patch after fail to relieve pain with conservative treatments. Pain scores, change in dosage of medications, side effects or complications were evaluated as well as degrees of patient satisfactions. Results: In overall, 51 patients (77.3%) showed substantial pain relief with improvement of QOL with satisfaction rate close to 70%. Average VAS in these patients decreased from 6.1 to 3.2. Also, 44 patients (66.7%) were able to reduce more than half of previous medications. There were no patients who developed serious withdrawal symptoms, dependence, and addiction after discontinuation of TDF. Conclusions: These results indicate the efficacy and safety of its use and no need for serious concern on drug abuse or addiction, when carefully selected and monitored. Thus, TDF is considered as a useful option in selected patients with chronic pain of neuropathic type, both peripheral and central.