芬太尼复合咪唑安定用于晚期癌痛病人自控静脉镇痛的疗效观察  

Effect of fentanyle combined midazolam for patient controlled intervenous analgesia in patients with advanced cancer.

作　　者：梁锐[1] 阮林[1] 潘灵辉[1] 黄冰[1] 钱卫[1] 黎阳[1] 

机构地区：[1]广西医科大学附属肿瘤医院,广西南宁530021

出　　处：《现代肿瘤医学》2005年第1期60-62,共3页Journal of Modern Oncology

摘　　要：目的　评价芬太尼复合咪唑安定用于晚期癌痛病人自控静脉镇痛 (patientcontrolledintervenousanalgesia, PCIA)的效果和安全性。方法　52例晚期癌痛患者随机分为实验组(芬太尼组,n=26)和对照组(吗啡组,n=26),接受PCIA治疗。实验组使用芬太尼,给药方式为持续给药 0. 01mg/h+PCIA给药 0.01mg/次,最大用量 0. 72mg/24h;对照组使用吗啡,给药方式为持续给药 0. 5mg/h+PCIA给药 0. 5mg/次,最大用量 36mg/24h。两组PCIA药液中均加入咪唑安定 20mg。结果　两组病人 24h总的疼痛缓解程度(totalpainrelief,TPR)分别为 18. 7±6. 5和 20. 8±7. 5(P>0. 05), 24h总的疼痛差值 (sumofpainintensitydiffer ences,SPID)分别为 45. 3±19. 6和 34. 6±18. 5(P<0. 05)。实验组病人副反应恶心、呕吐、头晕及嗜睡等副作用的发生率低于对照组,分别为 15. 4%和 30. 8% (P>0. 05)。结论　芬太尼复合咪唑安定可有效和安全地用于晚期癌痛病人自控静脉镇痛,效果与吗啡接近,与吗啡的等效剂量比为 1∶82,恶心、呕吐、头晕及嗜睡副反应发生率低于吗啡。Objective To investigate effective and safety of fentanyle combined midazolam for patient controlled intravenous analgestia(PCIA) in patients with terminal cancer. Methods Fifty-two patients with terminal cancer were randomly divided into experimental group(fentanyle,n=26) and control group(morphine,n=26). Two groups treated with PCIA.Experimental group:continue intravenous fentanyle 0.01mg per hour and bolus 0.01mg a time and maximal 0.72mg per 24 hours. Control group:continue intravenous morphine 0.5mg per hour and bolus 0.5mg a time and maximal 36mg per 24hours.The drugs of two groups contain 20mg of midazolam.Results Total pain relief(TPR)of two groups in twenty-four hours were 18.7±6.5 and 20.8±7.5(P>0.05).Sum of pain intensity differences of two groups in twenty-four hours were 45.3±19.6 and 34.6±18.5(P<0.05).The rate of side effect of experimental group was 15.4% and control group was 30.8%(P>0.05).Conclusion It is effective and safety of fentanyle combined midazolam for PCIA in patients with terminal cancer.It is equivalent 82 time of morphine.But side effect of it is lower compare with morphine.

关 键 词：芬太尼 吗啡 晚期癌痛 PCIA 

分 类 号：R730.5[医药卫生—肿瘤]