Hochdosis-Buprenorphin im Rahmen der ambulant-palliativen Schmerztherapie

Abstract

The case of a 78-year-old patient with cancer-related pain and additionally mixed-pain syndrome is presented. Pain therapy with buprenorphine TTS 210 microg/h every 3 days was sufficient in the beginning, later the therapy was changed because of increasing problems of tape fixing during fever periods under chemotherapy to a continuous infusion of buprenorphine intravenously via an external medication pump. During the course of therapy it became necessary to increase the dose to 99.9 mg/day buprenorphine. Under this medication a sufficient pain reduction (median NRS 2-3) over a period of 135 days could be achieved. At the same time the patient was vigilant and cooperative without signs of intoxication until the end of life at home in the presence of his family.If no signs of intoxication occur under extreme opioid therapy and a sufficient pain therapy can be achieved, a rotation to another opioid is not necessary. However, outpatient palliative care requires a frequent adaptation to the individually varying opioid demand of the patient and time-consuming nursing care.

The nociceptin/orphanin FQ receptor system as a target to alleviate cancer‐induced bone pain in rats: Model validation and pharmacological evaluation

“…Moreover, a possible involvement of the NOP receptor in cancerinduced bone pain has been suggested by the efficacy of cebranopadol, a mixed opioid/NOP receptor agonist (Linz et al, 2014), and buprenorphine, a mixed μ-opioid peptide/NOP partial agonist and κ-opioid peptide/δ-opioid peptide antagonist (Gastmeier & Freye, 2009) in rats. However, the present study is the first to reveal highly efficacious and potent relief of cancer-induced bone pain by selectively targeting the NOP receptor in rats.…”