舒芬太尼与曲马朵连续静脉泵注治疗阿片类药镇痛效果不佳的晚期癌痛

Continuous intravenous sufentanil and tramadoi for opioid resistant cancer pain

目的观察晚期癌痛用阿片类药效果不佳的患者应用连续静脉泵注舒芬太尼与曲马朵的镇痛效果。方法舒芬太尼3μg／ml及曲马朵10 mg/ml配置成总量100 ml,经静脉留置针持续泵入体内,速度为2 ml／h。结果8例晚期癌痛患者,经常规量阿片类药镇痛效果不佳,采用本法。应用最长1例17 d,最短4 d。VAS评分由平均8下降到2。全部患者对镇痛效果满意,但有恶心、便秘等副作用,经处理后改善或消失,未发现有明显的耐药现象。结论对于常规应用阿片类药物镇痛不佳的癌痛患者,舒芬太尼与曲马朵连续静脉泵注治疗晚期癌症疼痛是效果较好且安全的镇痛方法。

Objective To observe the effect of continuous infusion of sufentanil and tramadol by PCA pump on the advanced cancer pain, which was not satisfied with opioid. Methods Sufentanil 3 μg/ml and tramadol 10 mg/ml diluted with normal saline 100 ml was pumped intravenously 2 ml per hour. Results The pain relief in all patients was good, the longest one was 17 days, the shortest one 4 days. VASs were fallen clown significantly from 8 to 2. The side-effects such as constipation can be ameliorated or eliminated by treatments. Conclusion Continuous infusion of sufentanil and tramadol by PCA pump is one of the better way to control the advanced cancer pain, which was not satisfied with normal opioids dosage.