鼻内滴入舒芬太尼与皮下注射吗啡用于治疗癌性爆发痛的对比研究

A comparative study of intranasal sufentanil and subcutaneous morphine in emergency cancer breakthrough pain

目的:评估鼻内滴入舒芬太尼与皮下注射吗啡相比,在癌性爆发痛中的镇痛效果、安全性以及病人的满意度情况。方法:172例急诊就诊的癌性爆发痛病人按就诊时间的先后顺序进行数字编号,分为皮下注射吗啡(SIM)组、鼻内滴入舒芬太尼(INS)组,每组86人,记录不同治疗方式病人爆发痛发生时(T0)和经治疗后5 min(T1)、10 min(T2)、20 min(T3)、30 min(T4)和60 min(T5)的疼痛数字评分法(numerical rating scale,NRS)评分情况、不良事件和病人的满意度情况。结果:两种不同的治疗方式实施后,5 min、10 min和20 min时观察到INS组的NRS评分明显下降,优于SIM组(P<0.05);治疗后30 min分钟和60 min时NRS评分的降低组间比较无统计学差异。两组病人的不良事件发生率、满意度得分组间比较无显著性差异。结论:鼻内滴入舒芬太尼治疗癌性爆发痛起效快、操作方便、镇痛效果确切,可以作为一种新的解救癌性爆发痛的治疗方式。

Objective:To evaluate the analgesic effect of intranasal sufentanil compared with subcutaneous injection of morphine cancer breakthrough pain,the safety and patient satisfaction.Methods:One hundred and seventy-two patients with breakthrough cancer pain in the emergency department were randomly divided into 2 treatment groups,86 patients in each group:subcutaneous injection of morphine(SIM)group,intranasal sufentanil(INS)group.The patients’pain scores and adverse events at T0 and 5 min(T1),10 min(T2),20 min(T3),30 min(T4)and 60 min(T5),as well as the adverse events and satisfaction of patients in the two groups were recorded.Results:The NRS of the INS group was significantly reduced at 5 min,10 min and 20 min,which was better than the SIM group(P<0.05).The reduction of NRS at 30 min and 60 min after treatment was not statistically significant in the comparison between the two groups.There was no significant difference in the incidence of adverse events and satisfaction scores between the two groups.Conclusion:Intranasal sufentanil can be used as a new method in the treatment of breakthrough pain,which showed a quick onset,convenient operation and accurate analgesic effect.