Citation

Grellner W, Rettig-sturmer A, Kuhn-becker H, Wilske J. Proc. Int. Counc. Alcohol Drugs Traffic Safety Conf. 2002; 2002: 17-23.

Copyright

(Copyright © 2002, The author(s) and the Council, Publisher International Council on Alcohol, Drugs and Traffic Safety)

DOI

unavailable

PMID

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Abstract

It is questionable whether patients under a long-term therapy with oral opioids suffer from impairments of their driver fitness. In the present study, 20 ambulant patients with malignant and mainly non-malignant pains, 12 males and 8 females, with an average age of 50.6 10.4 years were included on a voluntary basis. They were treated with opioids of the WHO-stages II (n = 9) and III (n = 11). The test persons had to pass a computer-assisted test battery examining psychophysical parameters such as capacity, reaction time and alertness. Pupillographic sleepiness testing (PST) for the objective evaluation of daytime sleepiness was performed twice, before and after the test battery. There was a considerable interindividual variability concerning the measurable traffic-relevant capability. The total test group of opioid patients showed significant results below average of normal persons in the following parameters (p < 0.05): correct and omitted reactions in the determination test, reaction time and motor time in complex reaction tests. The PST parameters, pupillary unrest index (PUI) and amplitude spectrum, exceeded normal values significantly already in the first test and developed even worse in the second test after psychomotor evaluation. Patients under opioids WHO III revealed poor test results being significantly below the average in a greater number of testing methods than persons with opioids WHO II. The results point to the fact that patients under long-term opioid therapy show a significantly elevated daytime sleepiness that even increases after permanent performance. Psychophysical tests exhibited considerable prolongation especially in complex reaction tests with particularly marked deficits in patients under opioids of WHO-stage III. Someof the patients tested may therefore tend to fail in critical traffic situations or will not be able to meet all driving requirements. The driver fitness of opioid patients should be finally judged only after careful additional examinations in each single case.