Liu Hong-Jun, Li Wei-Yan, Chen Hao-Fei, Cheng Zhu-Qiang, Jin Yi
1 Department of Anesthesiology, Jinling Hospital, Nanjing, Peoples Republic of China, Nanjing, China.
Am J Hosp Palliat Care. 2017 Mar;34(2):148-153. doi: 10.1177/1049909115615110. Epub 2016 Jul 11.
Intrathecal analgesia is more effective than conservative delivery methods such as drugs administered orally or intravenously. Programmable devices such as Medtronic's SynchroMed systems have often been applied for long-term intrathecal analgesia. However, the totally implanted systems are very expensive in China. Considering cost-effectiveness, a reliable transmission protocol for a ZigBee-Based wireless analgesia pump system was used for long-term intrathecal analgesia in the home care of patients.
We retrospectively investigated the efficacy, side effects, and complications of long-term intrathecal analgesia in the home care of patients via the wireless analgesia pump system. Follow-up visits occurred monthly for the initial 3 months after implantation and then every 3 months until patient death, withdrawal from the study, or removal of the device by a designated staff. At each follow-up visit, daily average pain score, pain frequency, satisfaction level, Spitzer Quality of Life Index, and side effects for every patient were recorded.
Pain intensity and frequency were significantly decreased by intrathecal analgesia via a wireless analgesia pump system. There were no significant differences in the satisfaction levels between hospitalization and each follow-up visit. The Spitzer Quality of Life Indexes were improved compared with patients who were hospitalized. No serious side effects were observed in this study.
Intrathecal analgesia is an effective and safe method for control of refractory cancer pain, and wireless analgesia pump systems can be safely and effectively used for long-term intrathecal analgesia management in the home care of patients with advanced cancer.
鞘内镇痛比口服或静脉给药等传统给药方式更有效。美敦力公司的SynchroMed系统等可编程设备常被用于长期鞘内镇痛。然而，在中国，全植入式系统非常昂贵。考虑到成本效益，一种基于ZigBee的无线镇痛泵系统的可靠传输协议被用于晚期癌症患者居家护理中的长期鞘内镇痛。
我们回顾性研究了通过无线镇痛泵系统对晚期癌症患者居家护理中进行长期鞘内镇痛的疗效、副作用和并发症。植入后的前3个月每月随访一次，之后每3个月随访一次，直至患者死亡、退出研究或由指定人员取出设备。每次随访时，记录每位患者的每日平均疼痛评分、疼痛频率、满意度、Spitzer生活质量指数和副作用。
通过无线镇痛泵系统进行鞘内镇痛可显著降低疼痛强度和频率。住院期间与每次随访的满意度无显著差异。与住院患者相比，Spitzer生活质量指数有所改善。本研究未观察到严重副作用。
鞘内镇痛是控制难治性癌痛的一种有效且安全的方法，无线镇痛泵系统可安全有效地用于晚期癌症患者居家护理中的长期鞘内镇痛管理。
