Kubica-Cielińska Anna, Czapla Michał, Juárez-Vela Raúl, Tejada-Garrido Clara Isabel, Zielińska Marzena
Department and Clinic of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland.
Department of Paediatric Anaesthesiology and Intensive Care, University Hospital, 50-556 Wroclaw, Poland.
Cancers (Basel). 2022 Jul 25;14(15):3617. doi: 10.3390/cancers14153617.
Contemporary pain management regimens in children do not include the use of the middle step of the analgesic ladder, i.e., weak opioids. The aim of this study was to analyse the comparison of side effects and the therapeutic efficacy of morphine and nalbuphine in pain management in children with cancer. We conducted an observational, prospective study and analysed medical records of patients treated at the Clinic of Paediatric Haematology and Oncology of the University Hospital in Wroclaw (Poland), who developed mucositis during treatment. The efficacy and safety of both drugs were analysed, and the efficacy of pain relief and the incidence of adverse effects characteristic of opioid drugs were compared. The cases of 96 of children treated with opioid drugs nalbuphine or morphine were analysed. Nalbuphine therapy was accompanied by a statistically significantly lower incidence of side effects such as skin pruritus, constipation, and micturition disorders compared to morphine (p < 0.05). After the discontinuation of nalbuphine, signs of withdrawal syndrome were much less frequent than after morphine (p < 0.05). In Conclusion, nalbuphine used as a pain killer in children with oncological disorder is a safe drug. It provides stable analgesia in most children. Compared to morphine, the side effects typical of opioid use are less common, and the incidence decreases over time.
当代儿童疼痛管理方案不包括使用镇痛阶梯的中间步骤，即弱阿片类药物。本研究的目的是分析吗啡和纳布啡在癌症患儿疼痛管理中的副作用比较和治疗效果。我们进行了一项观察性前瞻性研究，分析了波兰弗罗茨瓦夫大学医院儿科血液学和肿瘤学诊所治疗的、在治疗期间发生口腔炎的患者的病历。分析了两种药物的疗效和安全性，并比较了疼痛缓解效果和阿片类药物特有的不良反应发生率。分析了96例接受阿片类药物纳布啡或吗啡治疗的儿童病例。与吗啡相比，纳布啡治疗伴随的皮肤瘙痒、便秘和排尿障碍等副作用发生率在统计学上显著更低（p < 0.05）。停用纳布啡后，戒断综合征的迹象比停用吗啡后少得多（p < 0.05）。总之，纳布啡用作肿瘤疾病患儿的止痛药是一种安全的药物。它在大多数儿童中提供稳定的镇痛效果。与吗啡相比，阿片类药物使用典型的副作用较少见，且发生率随时间降低。
