胸段硬膜外注射酚甘油治疗晚期癌痛

目的对比不同浓度酚甘油胸段硬膜外注射治疗晚期癌痛的镇痛效果。方法选择WHO 三阶梯止痛第三级药物治疗效果差的胸部、中上腹部或背部疼痛(VAS评分法均为8-10)的癌症患者60 例,随机分为A、B、C 3组。根据疼痛部位确定穿刺点行硬膜外穿刺,先注入1.5%利多卡因3-5ml,观察5min,无全脊麻症状,1次分别注入5%(A组)、10%(B组)、15%(C组)酚甘油溶液3-5ml。结果近期(24 h)镇痛效果C组明显优于A组(P<0.01),B组优于A组(P<0.05)。远期镇痛效果优良率高浓度组大于低浓度组,但无统计学意义。结论15%酚甘油胸段硬膜外注射用于晚期癌痛的镇痛效果优于低浓度组,且不增加并发症。

Analgesic effect of thoracic epidural phenol glycerin on the terminal cancer pain

Objective To compare the analgesic effect of phenol glycerin of different concentration in thoracic epidural space on terminal cancer pain. Methods Sixty cancer patients who had inefficient pain relief (VAS 8-10) with WHO third ladder medication in thorax, abdomen or back area were randomly divided into three groups, injecting epidurally 5%(A), 10%(B), 15%(C) phenol glycerin 3-5 ml. Results The analgesic effect of group C in the near period(24hours) were obviously excellent than that of group A (P<0.01) and group B were also excellent than group A (P<0.05).The effective rate of the high concentration group in long-term were better than that of the low concentration group,but had no statistically significant. Conclusion The analgesic effect of injecting phenol glycerin (15%) in the epidural space on the terminal cancer pain is better than that of low concentration with no increasing complications.