阿片类口服药物转换为芬太尼透皮贴的过渡期内癌痛患者镇痛方案研究

目的:探讨当阿片类药物口服止痛效果不佳需改用芬太尼透皮贴时,24 h过渡期内的最佳止痛方案.方法:建立随机对照试验,对80例符合标准的癌痛病例随机分组,分为吗啡注射液组、吗啡即释片组、阿片类缓释片亚组1、阿片类缓释片亚组2.比较各治疗组过渡期内镇痛效果、生活质量、不良反应种类及程度等,综合评价各组方案的疗效和安全性.结...

Analgesic protocol for patients with cancer pain during transition period from oral opioids to fentanyl transdermal patch

OBJECTIVE To explore the optimal analgesic protocol during the 24-hour transition period from poor analgesic effect of oral opioids to fentanyl transdermal patch.METHODS For this randomized controlled trial, 80 cancer pain patients were divided into morphine injection group, morphine ready-to-release tablet group, opioid sustained-release tablet subgroup 1 and opioid sustained-release tablet subgroup 2.Analgesic effect, quality-of-life, type and degree of adverse reactions during the transitional period were compared and the efficacy and safety of each regimen were comprehensively evaluated.RESULTS Analgesic effect:two subgroups of original opioid sustained-release tablets had stable control of overall analgesia and pain outbreak and opioid sustained-release tablets subgroup 1 achieved the best effect (NRS<3).As compared with two other groups, the onset time of pain was significantly later in opioid sustained release subgroup.As for quality-of-life, two subgroups of opioid sustained-release tablets significantly improved patient appetite as compared with two other groups.Opioid sustained-release tablet subgroup 1 could significantly improve mental state, sleep quality and daily activity.No significant difference existed in family understanding among four groups.As for adverse reactions, except for 4 cases of severe adverse reactions in morphine injection group, the other three groups showed mild adverse reactions.CONCLUSION Continuous dosing of original opioid extended-release drug may be more suitable as a "transitional" pain relief with fentanyl transdermal patch.The effect of adding the original drug once during the transition period is better, suggesting that the researchers need to further determine the final administration protocol through drug detection.