Singhal Yogendra, Pingoliya Surendra Kumar, Saji Sreeharsh, Gaurav R Pavan
Department of Palliative Medicine, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.
Indian J Palliat Care. 2024 Oct-Dec;30(4):375-379. doi: 10.25259/IJPC_141_2024. Epub 2024 Oct 1.
Morphine is the cornerstone of pain management in a palliative care setting. Nausea with or without vomiting usually occurs when patients are initiated on morphine for the 1 time or when the dose is substantially increased.
A total of 90 patients fulfilling the inclusion criteria were randomly allocated into two groups of 45 each. Group M received a tablet of metoclopramide 10 mg orally 3 times a day; Group H received a tablet of haloperidol (2.5 mg) orally at night. All the patients were provided NCI CTCAE V4.3 NAUSEA AND VOMITING SCALE and asked to mark their response from day 1 to day 7. At the follow-up visit on the 7 day, the form was collected, and data were analysed.
In Group M and Group H, the mean nausea score was between 1 and 2 and the difference was statistically insignificant. In Group M, the maximum vomiting score was 1.28 on day 5, while in Group H, the maximum score was 2 on day 5. The difference between the two groups was statistically significant.
Metoclopramide and haloperidol are equally efficacious in preventing nausea, but metoclopramide was found to be more effective with lesser side effects than haloperidol for morphine-induced vomiting in cancer patients when used prophylactically.
吗啡是姑息治疗中疼痛管理的基石。患者首次使用吗啡或大幅增加剂量时，通常会出现伴有或不伴有呕吐的恶心症状。
共有90例符合纳入标准的患者被随机分为两组，每组45例。M组患者每天口服3次10毫克胃复安片；H组患者每晚口服1片（2.5毫克）氟哌啶醇。所有患者均获得美国国立癌症研究所（NCI）CTCAE V4.3版恶心与呕吐量表，并要求他们从第1天至第7天记录自己的反应。在第7天的随访中，收集表格并分析数据。
M组和H组的平均恶心评分为1至2分，差异无统计学意义。M组在第5天的最大呕吐评分为1.28分，而H组在第5天的最大评分为2分。两组之间的差异具有统计学意义。
胃复安和氟哌啶醇在预防恶心方面同样有效，但预防性使用时，在预防癌症患者吗啡引起的呕吐方面，胃复安比氟哌啶醇更有效，且副作用更小。
