Liu Dong, Li Wei, Chen Li
Dong Liu, Department of Anesthesiology, Baoding No.1 Hospital, Baoding 071000, Hebei, China.
Wei Li, Department of Anesthesiology, Longyao county hospital, Xingtai 055350, Hebei, China.
Pak J Med Sci. 2023 Mar-Apr;39(2):561-566. doi: 10.12669/pjms.39.2.6664.
To compare the efficacy and side effects of sufentanil and morphine titration for patient-controlled subcutaneous analgesia (PCSA) in severe advanced cancer pain management.
A retrospective analysis was performed on the patients who were treated by two cancer centers with PCSA for severe advanced cancer pain at the Fourth Hospital of Hebei Medical University and Baoding No.1 Hospital between 2018 and 2021. These patients were divided into a sufentanil group and a morphine group. The drug dosage of the two groups was recorded. The pain intensity, sleep quality and adverse event rate (AER) were compared and analyzed between the two groups.
PCSA was successful in 95.2% (120/126) of the patients. In all cases, titration was successful within 24 hour, followed by oral administration of sustained-release opioid medications at 208.4 ±75.1 mg in the sufentanil group and at 207.9±66.3 mg in the morphine group. There was a significant difference in pain intensity and sleep quality before and after titration (P <0.05). Both groups exhibited a decline in their heart rates during titration. Compared with the baselines before titration, the mean heart rates were significantly reduced in both groups (P <0.05). The sufentanil group had an AER lower than that of the morphine group.
Short-term use of sufentanil supports PCSA for patients with severe advanced cancer pain can achieve effective and rapid pain management, it is worth clinical implementation and application.
比较舒芬太尼和吗啡滴定用于患者自控皮下镇痛(PCSA)在重度晚期癌痛管理中的疗效和副作用。
对2018年至2021年在河北医科大学第四医院和保定市第一医院两个癌症中心接受PCSA治疗重度晚期癌痛的患者进行回顾性分析。这些患者被分为舒芬太尼组和吗啡组。记录两组的药物剂量。比较并分析两组之间的疼痛强度、睡眠质量和不良事件发生率(AER)。
95.2%(120/126)的患者PCSA成功。在所有病例中,滴定均在24小时内成功,随后舒芬太尼组口服缓释阿片类药物208.4±75.1mg,吗啡组口服207.9±66.3mg。滴定前后疼痛强度和睡眠质量有显著差异(P<0.05)。两组在滴定过程中心率均下降。与滴定前基线相比,两组平均心率均显著降低(P<0.05)。舒芬太尼组的AER低于吗啡组。
短期使用舒芬太尼支持PCSA用于重度晚期癌痛患者可实现有效、快速的疼痛管理,值得临床推广应用。