モルヒネ内服の自己管理が"痛みの自己管理"を可能にする : くり返す骨折の痛みをコントロールした慢性関節リウマチ患者の1症例 "Patient-control" relief of severe rheumatic pain with oral morphine : A Case Report
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We reported good progress of pain control with oral morphine in a 64 year-old rheumatic female patient. She developed rheumatic arthritis twenty-two years ago (42 yrs.) and received corticosteroid therapy. Four years ago (60 yrs.), she had a sudden attack of severe pain due to vertebral fracture at 11th thoracic spine caused by long-term steroid-induced osteoporosis. Although she was obtained little improvement of pain by orthopedic management with stabilization-corset and non-steroidal anti-inflamatory drugs, she could secure effective pain relief with oral morphine therapy in our clinic based on "Yamagata (University) Method". It is out-patient supporting system consisted of patient-controlled oral morphine regimen and frequent telephone counseling about pain and adverse side effects of morphine (or other opioid analgesics), and aims to control pain by patients themselves. Thereafter she controlled pain well with the "Yamagata method" at six times whenever severe rheumatic fracture pain attacked to her. She is free from tolerance and mental dependence on morphine until now.<br> This case report shows that morphine is most reliable analgesics in the treatment of non-cancer severe pain at the present, and that patient-control pain relief with Yamagata method is suitable to gain full efficacy of oral morphine.
- PAIN RESEARCH
PAIN RESEARCH 22(1), 43-48, 2007-02-26
JAPANESE ASSOCIATION FOR STUDY OF PAIN