スコポラミン軟膏により，嚥下機能低下による流涎が減少した2例

―在宅診療での使用経験―

抄録

We report two cases in which drooling was reduced by percutaneous use of scopolamine ointment. Case 1: A 75-year-old female patient with amyotrophic lateral sclerosis (ALS). In addition to low-pressure continuous suction of the mouth, she was started on scopolamine ointment applied over the postauricular region. Before the ointment was prescribed, the volume of continuous suction was 400 ml/day, whereas it decreased to 150 ml on day 1 and to 200 ml on day 2 after the start of ointment application. Case 2: A 17-year-old female patient with cerebral palsy. If the score on Numeric rating scale (NRS) for the caregiver’s burden before the start of ointment application was 10, the score decreased to 2–4 after 4 hours and 1–3 after 24 hours of ointment application. Two and a half days after the ointment application, there was an objective increase in the amount of saliva, so that the application interval was shortened from every 3 days to every other day. Thereafter, there was a consistent decrease in the amount of saliva. Scopolamine is known to have side effects such as dryness of the mouth, drowsiness, blurred vision and mydriasis, constipation, and urinary retention. However, even after several months of use, no side effects have been observed in either case. We present some review of the literature, including on instructions for preparing and using scopolamine ointment.