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May 17, 2026THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA0 citationsOpen Access

Perioperative Analgesia Protocol for Photoimmunotherapy. 2 Cases of Seamless Care with Remifentanil

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RSReiko SatoTTTetsuya TAMURAMSMinHye So

Key Points

  • To create an effective perioperative analgesia protocol for patients undergoing photoimmunotherapy.
  • Utilized remifentanil continuously in the ICU post-surgery for approximately 6 hours before tapering off.
  • Combined remifentanil with IV-PCA fentanyl for pain management after extubation.
  • Presented findings in two cases of patients with recurrent oral and oropharyngeal cancers.
  • Both cases reported a maximum Numeric Rating Scale (NRS) pain score of 2 by the following morning.
  • Demonstrated seamless and high-quality analgesia during the perioperative period.
  • Indicated the need for further accumulation of cases and development of simpler, safer protocols.

Abstract

光免疫療法は光力学的に腫瘍細胞を破壊する新しいがん治療である．術後も腫瘍崩壊に伴う強い痛みが6時間程続くため，病室で疼痛管理に難渋することが多い．今回，icuで術後レミフェンタニルを継続使用するプロトコルを以下のように作成した．術後６時間程度レミフェンタニルを継続後，漸減・終了し人工呼吸器を離脱する．フェンタニルはiv-Pca機器を用いて併用し，呼吸器離脱後も使用する．【症例1】75歳の男性．口腔底癌が再発し，光免疫療法を施行．【症例2】75歳の男性．中咽頭癌と喉頭癌の再発巣に施行．ともに翌朝までのnrsは最高2．【結語】がん光免疫療法の周術期鎮痛プロトコルを作成し，2症例に適応した．シームレスで質の高い鎮痛が可能であった．今後は症例の蓄積とともに，より簡便で安全なプロトコルが望まれる．

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Cite This Study

Sato et al. (2025) studied this question.

synapsesocial.com/papers/6a095ac47880e6d24efe0a60https://doi.org/10.2199/jjsca.45.183
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