经鼻点滴枸橼酸芬太尼注射液用于控制爆发性癌痛的临床观察

Clinical observation of intranasal fentanyl citrate for the treatment of breakthrough cancer pain

目的探讨经鼻点滴枸橼酸芬太尼注射液用于控制爆发性癌痛(BTCP)的有效性。方法 18例晚期癌症且合并BTCP住院患者,均口服吗啡缓释片控制基础性癌痛,口服吗啡即释剂控制BTCP。随机分为两组(n=9):观察组在BTCP时改用枸橼酸芬太尼注射液1ml(50μg)滴鼻。对照组:继续用吗啡即释剂控制BTCP。结果观察组与对照组镇痛起效时间分别为(18.34±6.33)和(25.11±4.26)min,观察组显著短于对照(P<0.05)。观察组BTCP最大强度评分显著低于对照组(P<0.05),而患者满意度评分显著高于对照组(P<0.01)。结论枸橼酸芬太尼注射液滴鼻用于控制BTCP,给药方便,起效迅速,患者满意度高,有一定的临床应用价值。

Objective To investigate the effectiveness of intranasal fentanyl citrate for the treatment of breakthrough cancer pain（BTCP）. Methods 18 hospitalized terminal cancer patients combined with BTCP were taken morphine sustained release tablets to control background pain while morphine immediate release tablets to treat BTCP. They were randomized to two grounds （n = 9 ）, observation group （IF） patients used in- tranasal fentanyl citrate 1 ml （50 μg） when BTCP occurred and normal group （NM）patients continued to use morphine tablets. Results The onset time of analgesia in IF group and NM group were （ 18. 34 ± 6. 33 ） min and （ 25.11 ± 4. 26 ） rain. The IF group were obviously shorten than NM group （ P 〈 0.05 ）. The scores of BTCP maximum level were lower（ P 〈 0. 05 ） and degree of satisfaction were higher in IF group （ P 〈 0.01 ） compared with NM group. Conclusion Intranasal fentanyl citrate for the treatment of breakthrough cancer pain are convenient in administration and fast onset, patients get high degree of satisfaction and also have a certain clinical practice values.