|
|
|
| Clinical effect of Hydromorphone Hydrochloride in the treatment of patients with bone cancer pain and its influence on pain related mediators and hormone levels#br# |
| ZHANG Shengmao1 LI Na2 BAO Narisu1 SU Nan1 YUN Letian1 ZHAO Zhihui1 |
1.Department of Anesthesiology, Inner Mongolia People’s Hospital, Inner Mongolia Autonomous Region, Huhhot 010017, China;
2.Department of Pain Treatment, Hohhot First Hospital, Inner Mongolia Autonomous Region, Huhhot 010017, China |
|
|
|
Abstract Objective To investigate the analgesic effect and mechanism of Hydromorphone Hydrochloride in patients with bone cancer pain. Methods A total of 50 patients with bone cancer pain admitted to Inner Mongolia People’s Hospital from January 2017 to March 2020 were collected. They were divided into control group and observation group by random envelope method, with 25 cases in each group. The control group was treated with Disodium Pamidronate by intravenous analgesia pump, and the observation group was treated with Hydromorphone Hydrochloride by intravenous analgesia pump. Visual analogue scale (VAS) score and Karnofsky performance status (KPS) score were compared between two groups; the expression levels of pain mediators (5-hydroxytryptamine [5-HT], nitric oxide [NO], prostagrandin E2 [PGE2]) and stress hormones (cortisol [Cor], growth hormone [GH], prolactin [PRL]) were detected before treatment and 1, 2, and 3 months after treatment; the correlation between analgesic effect of Hydromorphone Hydrochloride and the levels of serum pain mediators and stress hormones in patients with bone cancer pain were analyzed. Results The analgesic effect of observation group was better than control group (P < 0.05). After 1 month of treatment, the levels of 5-HT, NO, PGE2, Cor, GH, and PRL in both groups were lower than those before treatment (P < 0.05); after 2 and 3 months of treatment, the levels of 5-HT, NO, PGE2, Cor, GH, and PRL in both groups were lower than those after 1 month of treatment (P < 0.05). After 1, 2, and 3 months of treatment, the levels of 5-HT, NO, PGE2, Cor, GH, and PRL in observation group were lower than those in control group (P < 0.05). VAS score was negatively correlated with the levels of serum 5-HT, NO, PGE2, Cor, GH, and PRL (r = -0.903, -0.675, -0.748, -0.706, -0.901, -0.621, P < 0.05); KPS score was negatively correlated with the levels of serum 5-HT, NO, PGE2, Cor, GH, and PRL (r = -0.801, -0.696, -0.738, -0.629, -0.752, -0.763, P < 0.05). Conclusion The therapeutic effect of Hydromorphone Hydrochloride on patients with bone cancer pain is better than that of traditional analgesics. The analgesic mechanism is related to inhibit the pain mediators and stress hormone levels.
|
|
|
|
|
|
[1] Zaj?諭czkowska R，Kocot-K pska M，Leppert W，et al． Bone pain in cancer patients：mechanisms and current treatment [J]．Int J Mol Sci，2019，20：6047-6066.
[2] Wang L，Huo M，Chen Y，et al. Tumor microenvironment-enabled nanotherapy [J]． Adv Healthc Mater，2018，7：e1701156-e1701178．
[3] Wu S，Pan Y，Mao Y，et al. Current progress and mechanisms of bone metastasis in lung cancer：a narrative review [J]. Transl Lung Cancer Res，2021，10（1）：439-451.
[4] Ribi K，Thürlimann B，Sch?覿r C，et al. Quality of life and pain in patients with metastatic bone disease from solid tumors treated with bone-targeted agents-a real-world cross-sectional study from Switzerland （SAKK 95/16） [J]. BMC Cancer，2021，21（1）：182.
[5] Olson KM，Duron DI，Womer D，et al. Comprehensive molecular pharmacology screening reveals potential new receptor interactions for clinically relevant opioids [J]. PLoS One，2019，14（6）：e0217371.
[6] Kim YS，Kim WY，Kim YH，et al. The protective effect of hydromor phone to ischemia in rat glial cells [J]. Springerplu，2016，5：610.
[7] 李志宏，冯亚楠.阶段性康复功能训练在股骨颈骨折患者术后的效果观察及对VAS评分影响分析[J].中国现代药物应用，2021，15（9）：235-237.
[8] 王永，解华，李凌云.贝伐珠单抗联合厄洛替尼对晚期非小细胞肺癌患者疗效、血清CYFRA21-1水平及KPS评分的影响[J].临床和实验医学杂志，2021，20（8）：827-830.
[9] 吴绍勇，冉启志，余华琴.帕米磷酸二钠减轻乳腺癌患者骨转移疼痛的效果与安全性[J].现代中西医结合杂志，2010，19（3）：314-315.
[10] 李波，何仲琴.氢吗啡酮微创给药对癌痛患者应用的安全性及有效性[J].实用癌症杂志，2016，31（10）：1731-1733.
[11] Bartels MMTJ，Verpalen IM，Ferrer CJ，et al. Combining radiotherapy and focused ultrasound for pain palliation of cancer induced bone pain； a stage Ⅰ/Ⅱa study according to the IDEAL framework [J]. Clin Transl Radiat Oncol，2021，27：57-63.
[12] Mao M，Li Y，Wang L，et al. Aitongxiao improves pain symptoms of rats with cancer pain by reducing IL-1，TNF-alpha，and PGE2 [J]. Int J Clin Exp Pathol，2021， 14（1）：133-139.
[13] Tillman EM，Ipe J，Weaver KJ，et al. Variability of Dosing and Number of Medications Needed to Achieve Adequate Sedation in Mechanically Ventilated Pediatric Intensive Care Patients [J]. Clin Transl Sci，2021，14（1）：310-316.
[14] Kirou-Mauro AM，Hird A，Wong J，et al. Has pain management in cancer patients with bone metastases improved? A seven-year review at an outpatient palliative radiotherapy clinic [J]. J Pain Symptom Manage，2009，37（1）：77-84.
[15] Gündost L，Koltka K，Sivrikoz N，et al. Effects of paravertebral block and intravenous analgesic methods on postoperative pain management and opioid consumption in laparoscopic cholecystectomies [J]. Agr，2020，32（4）：202-207.
[16] Koh JC，Kong HJ，Kim MH，et al. Comparison of Analgesic and Adverse Effects of Oxycodone- and Fentanyl-Based Patient-Controlled Analgesia in Patients Undergoing Robot-Assisted Laparoscopic Gastrectomy Using a 55：1 Potency Ratio of Oxycodone to Fentanyl：A Retrospective Study [J]. J Pain Res，2020，13：2197-2204.
[17] 王淅克，黄岩石，郑铁牛.LDH患者PGE2、5-HT及炎症细胞介质的变化与患者疼痛的关系[J].实验与检验医学，2020，38（1）：152-155.
[18] 李保奇，张育荣，罗远军.普瑞巴林联合盐酸羟考酮对癌性疼痛伴焦虑患者PGE2、5-HT水平的影响[J].现代医学与健康研究电子杂志，2020，4（3）：26-27.
[20] Liu J，Zhao C，Liu B，et al. Analgesia and curative effect of pamidronate disodium combined with chemotherapy on elderly patients with advanced metastatic bone cancer [J]. Oncol Lett，2019，18（1）：771-775.
[21] Koikawa K，Okada Y，Torimoto K，et al. Hyperparathyroidism Which Developed after Resection of a Fibroblast Growth Factor 23-producing Tumor [J]. Intern Med，2020，59（20）：2523-2527.
[22] Walia H，Tumin D，Wrona S，et al. Safety and efficacy of nurse-controlled analgesia in patients less than 1 year of age [J]. J Pain Res，2016，9：385-390.
[23] Coluzzi F，Caputi FF，Billeci D，et al. Safe Use of Opioids in Chronic Kidney Disease and Hemodialysis Patients：Tips and Tricks for Non-Pain Specialists [J]. Ther Clin Risk Manag，2020，16：821-837.
[24] Erlenwein J，Emons MI，Petzke F，et al. The effectiveness of an oral opioid rescue medication algorithm for postoperative pain management compared to PCIA：A cohort analysis [J]. Anaesthesist，2020，69（9）：639-648.
[25] Kim GH，Lee JW，Kim GE，et al. Analgesic effect of ropivacaine with fentanyl in comparison with ropivacaine alone for continuous femoral nerve block after knee replacement arthroplasty：a prospective，randomized，double-blinded study [J]. Anesth Pain Med（Seoul），2020，15（2）：209-216. |
|
|
|
