Pain Clinic, Department of Anaesthesiology and Reanimation, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Support Care Cancer. 2009 Dec;17(12):1475-81. doi: 10.1007/s00520-009-0612-8. Epub 2009 Apr 3.
The present study aimed to examine the effectiveness of intravenous administration of paracetamol added to morphine in the control of cancer pain and its possible contribution as reduction of opioid consumption and opioid-related side effects.
A total of 43 patients with chronic cancer pain without neuropathic origin aged between 18 and 76 years and receiving step 2 treatment according to the World Health Organization analgesic ladder were included. Patients were randomized to receive intravenous administration of saline (control) or 1 g of paracetamol on top of morphine. Visual analog scale (VAS), patient rating index (PRI), Eastern Cooperative Oncology Group (ECOG) status, patient satisfaction, and safety were evaluated.
Both treatments resulted in improved VAS and PRI scores compared to baseline. However, groups did not differ in terms of VAS and PRI scores, morphine consumption, side-effect frequencies, laboratory values, ECOG status, and patient satisfaction.
Although safe and there are signals for a true analgesic efficacy, our results failed to confirm any benefits of add-on treatment with intravenous administration of paracetamol. However, the study was underpowered, and future studies in this important area need to be wary of background noise and the risk of a type II error.
本研究旨在考察静脉注射扑热息痛联合吗啡控制癌痛的效果，以及减少阿片类药物消耗和相关副作用的可能性。
共纳入 43 例年龄在 18 至 76 岁之间、无神经病理性起源的慢性癌痛患者，根据世界卫生组织的镇痛阶梯接受 2 步治疗。患者随机接受静脉注射生理盐水（对照组）或吗啡加 1 g 扑热息痛。评估视觉模拟评分（VAS）、患者评分指数（PRI）、东部合作肿瘤学组（ECOG）状态、患者满意度和安全性。
与基线相比，两种治疗方法均使 VAS 和 PRI 评分得到改善。然而，两组在 VAS 和 PRI 评分、吗啡消耗、副作用频率、实验室值、ECOG 状态和患者满意度方面无差异。
尽管安全且有真正的镇痛效果信号，但我们的结果未能证实静脉注射扑热息痛联合治疗的任何益处。然而，该研究的效力不足，未来在这一重要领域的研究需要警惕背景噪音和 II 型错误的风险。
