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族・介護者が患者に代わってPCA を行ってもよいと結論した(中医協2005)。

【引用文献】1) Grochow L, Sheidler V, Grossman S, et al. Does intravenous methadone provide longer lasting analgesia than intravenous morphine? A randomized, double‒blind study. Pain 1989; 38: 151‒7 2) Kalso E, Vainio A, Mattila MJ, et al. Morphine and oxycodone in the management of cancer pain: plasma levels determined by chemical and radioreceptor assays. Pharmacol Toxicol 1990; 67: 322‒8 3) Björkman R, Ullman A, Hedner J. Morphine‒sparing effect of diclofenac in cancer pain. Eur J Clin Pharmacol 1993; 44: 1‒5 4) Vanier MC, Labrecque G, Lepage‒Savary D, et al. Comparison of hydromorphone continuous subcutaneous infusion and basal rate subcutaneous infusion plus PCA in cancer pain: a pilot study. Pain 1993; 53: 27‒32 5) Kalso E, Heiskanen T, Rantio M, et al. Epidural and subcutaneous morphine in the management of cancer pain: a double‒blind cross‒over study. Pain 1996; 67: 443‒9 6) Watanabe S, Pereira J, Tarumi Y, et al. A randomized double‒blind crossover comparison of

continuous and intermittent subcutaneous administration of opioid for cancer pain. J Palliat Med 2008; 11: 570‒4

【参考文献】a) McNicol ED, Ferguson MC, Hudcova J. Patient controlled opioid analgesia versus non‒patient controlled opioid analgesia for postoperative pain. Cochrane Database Syst Rev 2015; 6: CD003348 b) 中央社会保険医療協議会(中医協).医事法制における自己注射に係る取り扱いについて.2005年https://www.mhlw.go.jp/shingi/2005/03/dl/s0330‒7b.pdf (2019 年10 月17 日閲覧) III章推奨