痛力克甘油丁哌卡因用于晚期癌镇痛疗效的临床研究

Chinial study of mixture of toradol glycerine and bupivacaine of controling pain of ultimat term cancer

目的 :本着WHO提出 2 0 0 0年使癌症患者无疼的奋斗目标 ,努力寻找一个对癌痛治疗有效、合理、安全可靠、简单方便 ,易于基层掌握推广的止疼药和方法。方法 :选择 30例晚期癌痛病人 ,随机分成两组 ,每组各 1 5例 ,Ⅰ组用痛力克 1 0mg ,Ⅱ组用吗啡 2mg ,共同复合等量 5 0 %甘油和 0 75 %丁哌卡因 ,总量共 4ml,注入硬膜外腔止疼 ,观察两组药物止疼起效时间 ,止疼维持时间 ,镇痛效果 ,运动障碍情况及副作用。结果 :两组药在止疼起效时间平均 :Ⅰ组是 1 0 33± 1 .88min ,Ⅱ组是 9 93± 2 .0 2min ,总体P <0 0 1 ,组间比较 ΔP >0 0 5 ,患者个体间比较# P <0 0 5 ,说明P <0 0 1是因个体之间引起的 ,并非是两组药物间的差异 ;初次止疼平均时间 :Ⅰ组是 1 2 40± 1 72h ,Ⅱ组是 1 1 0 0± 0 5 3h ,P >0 0 5 ,ΔP >0 0 5 ,# P >0 0 5 ,提示两组药在初次止疼维持时间上无差异 ;再次给药平均止疼时间 ,Ⅰ组是 1 5 2 0± 4 79h ,Ⅱ组是 9 46± 1 5 9h ,P <0 0 1 ,ΔP <0 0 1 ,# P >0 0 5 ,P <0 0 1其差异是两组药物引起与个体无关 ;镇痛用VAS评估法 :Ⅰ组是 2 5 6 6± 0 2 88,Ⅱ组是 2 2 0± 0 2 96 ,P >0 0 5 ,ΔP >0 0 5 ,# P >0 0 5 ,两组药物在镇痛方面无差异。副作用方面 ,几乎全?

Objective:WHO suggests that by 2000 years a painless goal of cancer patienl will have been achieved.Controling pain of ultimate term cancer is a method which we is looking hard.Simultaneously the method must be logical.Safe and effective.Methods:thirty patients of ultimat can cer were allocated into toradol(group I n=15) and morphine group(group Ⅱ n=15).Mixture of toradal(10mg 0.6ml).0.75% bupivacain(15mg,2ml)and 50% glycerine(700mg,1.4ml)is used in group Ⅰ patient.Mixtare of morpline(2mg,0.6ml)0.75%.Bupivacaiu(15mg,2ml)and 50% glycerine(700mg,1.4ml)is used in group Ⅱ patient.The mixture(4ml)is injected into epidual cavity in order to observate Time of taking effect and maintaining for controling paine,result of analgesia.limited movement and side effects.Result:time of taking effect in group Ⅰ and Ⅱ average:group Ⅰ 10.33±1.88min,group Ⅱ 9.93±2.02mine.(P<0.01 in general,ΔP>0.05 between group Ⅰ and Ⅱ drug.# P<0.05 between patient and patient).Relatino between patient and patient results in P<0.01,which provds undifference betwwen group Ⅰ and group Ⅱ drug.At first,time of controling pain averages:group Ⅰ drug 12.40±1.72h,group Ⅱ drug 11.00±0.53h(P>0.05 ΔP>0.05 #P>0.05).Time of cortroling pain between group Ⅰ and group Ⅱ drug is not difference.Second,time of controling paing averages:group Ⅰ 15.20±4.79h,gruop Ⅱ 9.46±1.59h,(P< 0.001 ,ΔP<0.01,#P>0.05).Obvious diffevence of P<0.01 is caused by group Ⅰ and group Ⅱ drug.VAS of analgesia estimates:group Ⅰ 2.566±0.288,group Ⅱ 2.20±0.296(P>0.05,ΔP>0.05,#P>0.05).The controling pain between group Ⅰ and group Ⅱ drug is not difterence.Side effect results from all of group Ⅱ drug.Conclusion:The controling pain of toradol is similar to morphine.Time of toradol in controling pain again is more long than that of morphine and compared with morphines it does not have a series of side effects. [