舒芬太尼与吗啡快速静脉滴定治疗晚期难治性癌痛的疗效比较*

Efficacy comparison between sufentanil and morphine rapid intravenous titration treatment in advanced refractory cancer pain

摘要:

目的 对比静脉舒芬太尼和吗啡快速滴定治疗晚期难治性癌痛的镇痛效果和不良反应。方法 分析了80例舒芬太尼和68例吗啡通过静脉自控镇痛(patient-controlled intravenous analgesia, PCIA)快速滴定改善晚期癌性疼痛患者,滴定前按照阿片药物等效剂量关系将阿片药物用量换算为静脉舒芬太尼注或吗啡用量,患者自控给药滴定24小时后转换为芬太尼贴剂,对比两组治疗前后的疼痛评分、睡眠质量及滴定期间和滴定后的不良反应。结果 两组患者在滴定转换为芬太尼贴剂后疼痛无显著差异(P<0.05),舒芬太尼组的不良反应的发生率较低。结论 舒芬太尼注射剂和吗啡注射剂用于癌痛的快速滴定治疗均表现为良好的镇痛效果。相对于吗啡注射剂,舒芬太尼的不良反应发生率更低。

Abstract:

objective To compare the analgesic effects and adverse reactions between sufentanil and morphine rapid titration treatment in advanced refractory cancer pain. Method Eighty cases of advanced cancer pain were treated with sufentanil, 68 patients were treated with morphine by rapid patient-controlled intravenous analgesia(PCIA) titration to control pain. Before titration, the dosage of opiate drugs was converted to intravenous sufentanil or morphine doses according to the equivalent dose relationship of opiates. 24 hours after titration, the sufentanil or morphine doses were converted to fentanyl patches. Pain scores and sleep quality were compared between the two groups before and after treatment. Adverse reactions were recorded from the beginning titration. Result There were no significant differences in pain scores, sleep quality scores between two groups after titration (P < 0.05), in addition, the pain and sleep quality scores were significantly lower. Results comparing to morphine group, sufentanil group had a lower incidence of adverse reactions. Conclusion Both sufentanil and morphine injection showed good analgesic effect in the rapid titration treatment of cancer pain. Compared with morphine injection, sufentanil had a lower incidence of adverse reactions.