鼻内滴入舒芬太尼与皮下注射吗啡用于治疗急诊癌性爆发痛的对比研究

Intranasal sufentanil and subcutaneous injection of morphine for the treatment of emergency cancer breakthrough pain: a randomized controlled study

摘要:

目的：评估鼻内滴入舒芬太尼与皮下注射吗啡相比，在癌性爆发痛中的镇痛效果、安全性以及患者的满意度情况。方法：172例急诊就诊的癌性爆发痛患者随机分为2个治疗组，每组86人：皮下注射吗啡(SIM)组、鼻内滴入舒芬太尼(INS)组，记录不同治疗方式患者爆发痛发生时T0和经治疗后 10 min (T1)、20 min (T2)、 30 min (T3) 和60 min (T4) 的疼痛评分情况、不良事件和患者的满意度情况。结果：两种不同的治疗方式实施后，10 min和20min时观察到INS组的 NRS 明显下降，优于SIM组；治疗后30 min分钟和60 min时NRS 的降低在组间比较中没有发现统计学差异。结论：鼻内滴入舒芬太尼治疗癌性爆发痛起效快、操作方便、镇痛效果确切，可以作为一种新的解救癌性爆发痛的治疗方式。

Abstract:

Objective: To evaluate the analgesic effect of intranasal sufentanil compared with subcutaneous injection of morphine in a cancer breakthrough pain, safety and patient satisfaction. Methods: 172 patients with breakthrough cancer pain in the emergency department were randomly divided into 2 treatment groups, 86 patients in each group: subcutaneous injection of morphine (SIM) group, intranasal sufentanil (INS) group. Record the patients' pain scores and adverse events at T0 and 10 min (T1), 20 min (T2), 30 min (T3) and 60 min (T4), and the patients' satisfaction after treatment the breakthrough pain. Results: The NRS of the INS group was significantly reduced at 10 min and 20 min, which was better than the SIM group. The reduction of NRS at 30 min and 60 min after treatment was not statistically significant in the comparison between the two groups. Conclusion: Intranasal sufentanil can be used as a new method in the treatment of breakthrough pain,which showed a quick onset, convenient operation and accurate analgesic effect.