50%-50%氧化亚氮-氧气混合物用于癌性爆发痛的镇痛效果观察

Observation on Analgesic Effect of 50%-50% Nitrous Oxide-oxygen Mixture for Breakthrough Cancer Pain

目的观察50%-50%氧化亚氮-氧气混合物用于癌性爆发痛的镇痛效果。方法将78例癌性爆发痛患者分为两组:实验组(42例)口服即释型吗啡,同时吸入50%-50%氧化亚氮-氧气混合物。对照组(36例)口服即释型吗啡,并吸入100%氧气。观测镇痛治疗前、镇痛治疗后5min、15min以及爆发痛得到控制后5min 4个时间点(依次为T1、T2、T3和T4)患者的心率、平均动脉压、血氧饱和度和视觉模拟评分(VAS)。疼痛控制后对患者进行镇痛效果满意度调查。结果实验组和对照组患者在T1、T4时各指标差异均无统计学意义(P均>0.05)。在T2、T3时,实验组的心率、平均动脉压、VAS评分均低于对照组(P均<0.05)。T2时实验组患者的血氧饱和度较对照组低(P<0.05)。实验组的镇痛效果满意比例高于对照组(χ2=4.748,P=0.029)。结论50%-50%氧化亚氮/氧气混合物用于癌性爆发痛可以迅速缓解疼痛,对呼吸和血流动力学影响小,病人满意度高。

Objective To observe the analgesic effect of 50%-50%nitrous oxide-oxygen mixture for breakthrough cancer pain.Methods Patients with breakthrough cancer pain were divided into two groups.In experimental group,the patients received oral immediate release morphine and inhaled 50%-50%nitrous oxide-oxygen mixture;and in control group,the patients received oral immediate release morphine and inhaled 100%oxygen.Heart rate,mean arterial pressure,blood oxygen saturation and visual analogue score(VAS)were observed before the analgesic therapy,5 and 15 minutes after analgesic therapy and 5 minutes after the breakthrough pain was controlled(T1,T2,T3,and T4,respectively).Satisfaction survey on pain control was evaluated.Results A total of 78 patients were included in the study,42 of which were in the experimental group and 36 in the control group.There were no significant differences in the indexes between the two groups at T1 and T4 time points(P>0.05).But,at T2 and T3,the heart rate,mean arterial pressure and VAS scores of the experimental group were lower than those of the control group,and the differences were significant(P<0.05).Meanwhile,the satisfaction survey of the experimental group was higher than that of the control group,and the difference was significant(χ2=4.748,P=0.029).Conclusion 50%-50%nitrous oxide/oxygen mixture can quickly relieve breakthrough cancer pain,with little effect on respiratory and hemodynamics,and with high patient satisfaction.