摘要
目的探讨芬太尼鼻腔给药应用于癌症疼痛治疗的有效性、安全性。方法选择中晚期癌症并伴有中、重度持续性疼痛患者80例,分为两组:A组:左右鼻腔喷入芬太尼各10μg+静脉注射生理盐水2 mL;B组:静脉注射芬太尼20μg(2 mL)+鼻腔喷入生理盐水,每组间隔5 min给药1次,每组共3次。两组患者分别在用药前(T0)、第1次用药后5 min(T1)、10 min(T2)、15 min(T3)、25 min(T4)、35 min(T5)时测定Prince-Henry疼痛评分和HR、SBP、DBP等生命特征,以及用药后SpO2<95%发生率,并记录不良反应发生情况。结果 B组Prince-Henry疼痛评分在T3及T4时间点明显低于A组,组间存在统计学差异,T0、T1、T2、T5时间点两组Prince-Henry疼痛评分无统计学差异;在T3时间点,B组的HR明显低于A组,存在统计学差异,A组与B组各时间点的血压无统计学差异。A组出现一过性低血氧状态5例,B组13例。A组出现恶心3例,呕吐2例,B组出现恶心7例,呕吐3例,均对症治疗后好转。本试验提示了芬太尼鼻腔喷雾泵给药有效,且较静脉给药安全易操作。结论小剂量芬太尼喷鼻能够安全、有效地控制癌症爆发性疼痛。
Objective To evaluate the safety and efficacy of intranasal fentanyl on breakthrough pain in patients with carcinoma. Methods Eighty patients with advanced carcinoma were randomly divided into 2 groups with forty cases in each group. Group A： fentanyl 10 μg was sprayed in each nasal and normal saline 2 mL was infused by intravenous. Group B ： normal saline was sprayed in nasal and fentanyl 20 μg/2 mL was infused by intravenous. Every patient of the two groups was treated once interval of 5 min with a total of three times. The Prince-Henry scale and HR, SBP, DBP were recorded before treatment with fentanyl（T0） and 5 min（T1）, 10 min（T2）, 15 min（T3）, 25 min（T4） and 35 min （T5） after fentanyl administration. Results Compared with group A on T3 and T4, Prince-Hemy pain scores of group B was significantly lower （P 〈 0.01）. Compared with group A on T3, HR of group B was significantly lower （P 〈 0.01）. There was no significant difference in SBP and DBP between the two groups. Group A nausea （3 cases）, vomiting in 2 cases, group B 7 cases were nausea, vomiting （3 cases）, were relieved after symptomatic treatment. Conclusion A small dose of intranasal fentanyl offer a rapid, effective, safe method to relieve beakthrough pain in patients with carcinoma.
出处
《中国现代医生》
2013年第19期44-46,共3页
China Modern Doctor
基金
广东省韶关市医药卫生科研计划(Y13156)
