内容紹介
Efficacy of a Fentanyl Citrate Buccal Tablet for Esophageal Cancer Pain Management in a Patient Unable to Take Oral Medication
Summary
We report a case of a 60-year old male esophageal cancer patient who was unable to take oral medication, but was successfully treated using a fentanyl citrate buccal tablet. The patient survived a suicide attempt as a youth in which he ingested poison, but was left with a stricture of the esophagus. It became difficult for him to take nutrition orally, and he underwent an esophageal bypass operation, although he still required frequent endoscopic esophageal dilation. He subsequently presented with an anastomotic stenosis due to anastomotic leakage, and oral intake became completely impossible. The onset of esophageal cancer presented as corrosive esophagitis. We used oxycodone hydrochloride to treat a sharp pain resulting from cataplectic cancer in the jejunal tube, but this provided only limited pain relief. We therefore used a fentanyl citrate oral mucosa absorption preparation with a rescue agent, which did provide effective pain relief. Thus a fentanyl citrate buccal tablet could effectively relief pain in cancer patients who are unable to receive oral medication.
要旨
患者は60歳,男性。若年時に服毒による自殺を図り,食道狭窄を生じた。頻回の食道ブジーを試みるも,食餌の通過困難となり食道バイパス術を施行。しかし,術後縫合不全による吻合部狭窄を来し,経口不能となった。同時に,腐食性食道炎の部位に食道癌の発症を認めた。食道癌の突出痛に対しては,オキシコドン塩酸塩によるレスキューが必要であった。フェンタニルクエン酸塩口腔粘膜吸収製剤に変更後,突出痛の消失が得られた。経口摂取困難な癌患者の疼痛コントロールにフェンタニルクエン酸塩口腔粘膜吸収製剤は有効と思われた。
目次
Summary
We report a case of a 60-year old male esophageal cancer patient who was unable to take oral medication, but was successfully treated using a fentanyl citrate buccal tablet. The patient survived a suicide attempt as a youth in which he ingested poison, but was left with a stricture of the esophagus. It became difficult for him to take nutrition orally, and he underwent an esophageal bypass operation, although he still required frequent endoscopic esophageal dilation. He subsequently presented with an anastomotic stenosis due to anastomotic leakage, and oral intake became completely impossible. The onset of esophageal cancer presented as corrosive esophagitis. We used oxycodone hydrochloride to treat a sharp pain resulting from cataplectic cancer in the jejunal tube, but this provided only limited pain relief. We therefore used a fentanyl citrate oral mucosa absorption preparation with a rescue agent, which did provide effective pain relief. Thus a fentanyl citrate buccal tablet could effectively relief pain in cancer patients who are unable to receive oral medication.
要旨
患者は60歳,男性。若年時に服毒による自殺を図り,食道狭窄を生じた。頻回の食道ブジーを試みるも,食餌の通過困難となり食道バイパス術を施行。しかし,術後縫合不全による吻合部狭窄を来し,経口不能となった。同時に,腐食性食道炎の部位に食道癌の発症を認めた。食道癌の突出痛に対しては,オキシコドン塩酸塩によるレスキューが必要であった。フェンタニルクエン酸塩口腔粘膜吸収製剤に変更後,突出痛の消失が得られた。経口摂取困難な癌患者の疼痛コントロールにフェンタニルクエン酸塩口腔粘膜吸収製剤は有効と思われた。