背景滴定用于阿片类药物耐受癌痛患者的可行性分析

Feasibility of background morphine titration for management of cancer pain in opioid tolerant patients

目的探讨背景滴定用于阿片类药物耐受癌痛患者镇痛治疗的可行性。方法 38例阿片类药物耐受的癌痛控制不稳定患者,分为背景滴定组和短效吗啡滴定组分别进行滴定,比较两组患者滴定周期、最高疼痛评分、滴定达稳态时间、滴定达稳态阿片类药物剂量及不良反应。结果背景滴定组与短效吗啡滴定组的滴定周期分别为(1.4±0.5)、(2.1±0.8)次,滴定达稳态时间分别为(19.9±10.2)、(24.5±8.4)h,滴定过程中最高疼痛评分分别为(5.4±0.8)、(6.3±0.9)分,两组间比较均有统计学差异(均P<0.05);两组不良反应发生率则无统计学差异(P>0.05)。结论背景滴定用于阿片类药物耐受癌痛患者的镇痛治疗,疼痛控制迅速平稳,不良反应可耐受,是一种安全有效的镇痛治疗方案。

Objective To examine the efficacy and safety of background intravenous morphine titration for the manage-ment of cancer pain in opioid tolerant patients. Methods Thirty eight opioid tolerant patients with uncontrol ed cancer pain were divided into two groups：background titration group and short- action morphine titration group. The titration cycles, the highest numerical rating scale （NRS）, the time to steadily pain control, the dosage of opioid analgesics and adverse effect were com-pared between two groups. Results The titration cycle, the highest numerical rating scale and the time to steadily pain control in background titration group and short- acting morphine titration group were（1.4 ±0.5）vs（2.1 ±0.8）,（5.4 ±0.8）vs（6.3 ±0.9） and（19.9±10.2）h vs（24.5±8.4）h, respectively（al P〈0.05）.There were no statistical differences in the occurrence of adverse effect between two groups （P〉0.05）. Conclusion Background titration is rapid, steady and safe for the management of cancer pain in opioid tolerant patients.