Abstract：Objective To study the analgesic effect and safety of Dexmedetomidine combined with Hydromorphone on breakthrough cancer pain (BTcP). Methods Ninety-six patients with BTcP in Liyang Branch, Jiangsu Provincial People’s Hospital from February 2020 to February 2021 were selected, they were divided into control group and observation group, with 48 cases in each group. The control group was treated with Hydromorphone for analgesia, and observation group was treated with Dexmedetomidine combined with Hydromorphone for analgesia. The analgesic effect (drug onset time, drug action time, dosage of self-controlled Hydromorphone, dosage of remedial analgesia, numerical rating scale [NRS] score, and pain degree) were compared between two groups within seven days of treatment; sleep quality (Athens insomnia scale [AIS] score) and quality of life (Spitzer quality of life index [SQOL] score) were compared before and after seven days of treatment; the total incidence of adverse reactions and satisfaction of analgesia during treatment were compared. Results Drug onset time in observation group was shorter than that in control group, drug action time was longer than that in control group, the dosage of self-controlled Hydromorphone and dosage of remedial analgesia were less than those in control group, and NRS score of BTcP attack and severity were lower than those in control group (P < 0.05). Seven days after treatment, AIS scores of two groups were lower than those before treatment, SQOL scores of two groups were higher than those before treatment, and AIS score of observation group was lower than that of control group, and SQOL score was higher than that of control group (P < 0.05). There was no significant difference in the total incidence of adverse reactions between two groups (P > 0.05). The analgesic satisfaction of observation group was better than that of control group (P < 0.05). Conclusion Dexmedetomidine combined with Hydromorphone in BTcP analgesic effect is obvious, can reduce the degree of pain, improve sleep quality and quality of life, will not increase the occurrence of adverse reactions, and patients have high satisfaction with analgesia, which is worthy of clinical promotion.
潘燕萍1 王樱1 王振红2. 右美托咪定联用氢吗啡酮对癌性爆发痛的镇痛效果及安全性[J]. 中国医药导报, 2022, 19(22): 100-103.
PAN Yanping1 WANG Ying1 WANG Zhenhong2. Analgesic effect and safety of Dexmedetomidine combined with Hydromorphone on breakthrough cancer pain. 中国医药导报, 2022, 19(22): 100-103.
[1] 中国抗癌协会癌症康复与姑息治疗专业委员会难治性癌痛学组，中华医学会疼痛学分会癌痛学组.癌性爆发痛专家共识（2019年版）[J].中国肿瘤临床，2019，46（6）：267-271.
[2] 黄文广，林仙菊，汪小丹，等.癌症爆发痛的研究进展[J].中国疼痛医学杂志，2019，25（4）：293-297.
[3] 喻超.羟考酮缓释片联合吗啡即释片用于门诊中—重度癌痛患者药物初始剂量滴定的临床观察[D].沈阳：中国医科大学，2019.
[4] 袁玉辉，马改改.氢吗啡酮与硫酸吗啡控释片对中重度癌症疼痛患者的镇痛效果对比[J].右江医学，2019，47（7）：520-522.
[5] Zhang T，Yu Y，Zhang W，et al. Comparison of dexmedetomidine and sufentanil as adjuvants to local anesthetic for epidural labor analgesia： a randomized controlled trial [J]. Drug Des Devel Ther，2019，11（13）：1171-1175.
[6] 赵东丽，梁宪斌，张喜凤，等.舒芬太尼静脉自控镇痛联合加巴喷丁及度洛西丁治疗顽固性癌痛2例并文献复习[J].临床医学，2019，39（1）：124.
[7] 沈慧芬，高聚伟，张卫平.自控镇痛技术在胰腺癌难治性疼痛治疗中的应用[J].中国疼痛医学杂志，2021，27（3）：239-240.
[8] 严广斌.NRS疼痛数字评价量表numerical rating scale[J].中华关节外科杂志（电子版），2014，8（3）：410.
[9] Soldatos CR，Dikeos DG，Paparrigopoulos TJ. Athens Insomnia Scale：validation of an instrument based on ICD-10 criteria [J]. J Psychosom Res，2000，48（6）：555-560.
[10] Hird A，Wong J，Zhang L，et al. Exploration of symptoms clusters within cancer patients with brain metastases using the Spitzer Quality of Life Index [J]. Support Care Cancer，2010，18（3）：335-342.
[11] 陈霁.盐酸吗啡即释片和盐酸羟考酮缓释片治疗中重度癌性疼痛的效果观察[J].当代医药论丛，2019，17（17）：26-27.
[12] 陈丽，邢冬，国丽茹，等.舒芬太尼滴鼻与皮下注射吗啡治疗癌性爆发痛的临床效果比较[J].中国疼痛医学杂志，2020，26（11）：874-876.
[13] 曾慧憬，吴新俊，林生，等.无线镇痛泵系统自控镇痛用于癌性爆发痛的临床观察[J].临床和实验医学杂志，2020， 19（11）：1225-1228.
[14] Nijland L，Schmidt P，Frosch M，et al. Subcutaneous or intravenous opioid administration by patient-controlled analgesia in cancer pain：a systematic literature review [J]. Support Care Cancer，2019，27（1）：33-42.
[15] 朱海萌，张洁，吴一珍，等.右美托咪定联合吗啡皮下注射自控镇痛用于癌性爆发痛的疗效观察[J].国际麻醉学与复苏杂志，2020，41（8）：753-758.
[16] 张宇，唐轶珣，历欧，等.氢吗啡酮鞘内药物输注系统用于难治性癌痛病人的研究[J].中国疼痛医学杂志，2019， 25（11）：823-830.
[17] Huang G，Liu G，Zhou Z，et al. Successful Treatment of Refractory Cancer Pain and Depression with Continuous Intrathecal Administration of Dexmedetomidine and Morphine：A Case Report [J]. Pain Ther，2020，9（2）：797-804.
[18] 毕磊.盐酸右美托咪定联合氢吗啡酮静脉自控镇痛在脑瘫患儿术后的临床应用观察[J].中国临床医生杂志，2019，47（1）：95-98.
[19] 盛莉，康延海，陈邓林，等.右美托咪定联合静脉自控镇痛对阿片类药物耐受-口服困难癌痛患者的疗效分析[J].长春中医药大学学报，2021，37（2）：330-333.
[20] 程小桂，安琳娜.癌症终末期患者睡眠欠佳伴疼痛一例用药分析[J].中国药物与临床，2021，21（3）：477-479.
[21] 佟春雨，杨玲.姑息治疗对晚期癌症患者癌性疼痛，食欲，睡眠质量及焦虑抑郁的影响[J].国际精神病学杂志，2021，48（4）：5.
[22] 王玥，范东毅，杨禄坤.氢吗啡酮复合右美托咪定在胸腹腔镜术后静脉镇痛中的应用[J].中国新药与临床杂志，2021，40（11）：3.
[23] 上官扬琴，刘鉴，何佩玲，等.氢吗啡酮复合右美托咪定用于全膝关节置换术的静脉自控镇痛的效果[J].中国伤残医学，2019，27（13）：56-57.
[24] Nair AS，Saifuddin MS，Naik V，et al. Dexmedetomidine in cancer surgeries：Present status and consequences with its use [J]. Indian J Cancer，2020，57（3）：234-238.
[25] 杨蒙，赵录琳，李建新，等.小剂量右美托咪定静脉自控镇痛对喉癌患者术后应激反应和康复效果的影响[J].山西医药杂志，2019，48（9）：1010-1013.
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