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OBJECTIVE@#To compare the clinical effect of wrist-ankle needle combined with opioid drugs and opioid drugs alone in treating refractory cancer pain.@*METHODS@#Sixty patients were randomly divided into an observation group and a control group, 30 cases in each one. The opioid drugs in accordance with the three-step analgesic principle and other auxiliary drugs were treated in the control group. On the basis of the treatment in the control group, wrist-ankle needle was added in the observation group, and acupoints were selected according to the pain site and the primary focus, the treatment was given once a day for 10 days. The visual analogue scale (VAS) score, the times of pain outbreaks and the incidence of adverse reactions were compared at the 2nd, 4th, 6th, 8th and 10th days of treatment and the 3rd and 7th days after treatment. The therapeutic effect in the two groups were compared after treatment.@*RESULTS@#Compared with the control group, the VAS scores in the observation group were significantly reduced from the 2nd day of wrist-ankle needle treatment, and continued to the 3rd day after the end of the treatment (0.05); compared with the control group, the times of pain outbreaks in the observation group decreased from the 2nd day to the 10th day of treatment (all <0.05); the incidence of nausea, vomiting and constipation in the observation group was significantly reduced compared with the control group (<0.05); the total effective rate in the observation group was 86.7% (26/30), which was higher than 76.7% (23/30) in the control group (<0.05).@*CONCLUSION@#Wrist-ankle needle combined with opioid drugs can increase the efficacy of the refractory cancer pain and reduce the adverse reactions of opioid drugs.
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Humans , Acupuncture Analgesia , Methods , Analgesics, Opioid , Therapeutic Uses , Ankle , Cancer Pain , Therapeutics , Treatment Outcome , WristABSTRACT
Objective To evaluate the effect of preoperative anxiety on the dosage of opioid drugs in perioperative period.Methods Fourty female patients who aged 18-65 years,ASA Ⅰ or Ⅱ, undergoing laparoscopic hysterectomy were enrolled during November 2014 to August 2015.Demo-graphic characteristics of the patients were recorded.The patients were separated into two groups ac-cording to their state anxiety inventory (SAI).The patients with SAI>37 score were included in the high-anxious patients group (group H,n=22)while the other patients with SAI≤37 were enrolled in the low-anxious patients group (group L,n=18).All patients received the SAI test at the day be-fore surgery.The anesthesia time,intraoperative remifentanil consumption,duration of the first time giving analgesia after surgery,consumption of sufentanil at 1(T1 ),2(T2 ),4(T3 ),6(T4 ),24(T5 ) and 48 hours(T6 )after operation were recorded.Visual analogue scale (VAS)scores,the times of pressing PCIA and the side effects of opioid 48 h after the surgery were recorded.Results In group H, the time for first dose of opioid after surgery was significantly shorter than group L (P <0.05).The con-sumption of sufentanil in group H was significantly more than group L at T1-T6 (P <0.05).The times of pressing PCIA at the T5 time point after operation in group H was more than group L (P<0.05).No sta-tistically difference was found in the incidence of nausea or vomit between the two groups.There were no re-spiratory depression, pruritus or urinary retention in all patients.Conclusion Patients with high preoperative anxiety level perceive needed more opioids in postoperative pain control.
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Objective:To study the stability of dexmedetomidine combined with three opioid drugs ( sufentanil, fentanil and butor-phanol) in order to guide the reasonable clinical prescription. Methods:Dexmedetomidine was respectively combined with sufentanil, fentanil and butorphanol in 0. 9% sodium chloride injection. The mixture was stored at room temperature for 0, 24, 48 and 96h, and then withdrawn for the detection of appearance, pH value, insoluble particles, and the analysis of mass spectrometry was performed. Results:Within 96 h, the prepared solutions were clear and transparent with stable pH value and qualified insoluble particles, and the results of mass spectrometry showed no new substance was generated. Conclusion:The three combination schemes are safe, reasonable and feasible in clinical application.
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Objective To investigate the distribution of moderate to severe cancer pain and administrated dose of opioid drugs in order to provide the reference for the treatment of moderate and severe cancer pain.Methods Retrospective analyzed the clinical data of 146 patients with moderate to severe cancer pain.The information were recorded including opioid use dose,cancer pain incidence,age,gender,height,weight,body surface area and type of tumor.Results There were no significant difference among patients with opioids drug administration in terms of gender,average daily oral dose(x2 =0.473,Z =-0.185,P ＞ 0.05).Meanwhile cancer incidence rate was same in different age groups (x2 =2.280,P =0.684).The average daily opioid dose in patients with over 80 year old was the lowest among other age groups (Z =-2.745,-1.986,-2.141,-2.162;P ＜0.05).Cancer pain incidence in patients with hepatobiliary pancreatic tumors were 67.50％ (27/40),highest than other different types cancer including metastatic tumor(62.50％ (10/16)),urinary tumor (61.54％ (8/13)),lung cancer (52.63％ (50/95)),breast cancer and gynecological tumor (50.00％ (17/34)),gastrointestinal tumor(41.94％ (26/62)),other tumors 38.46％ (5/13) and head and neck tumor(25.00％ (3/12)),the difference was statistically significant (x2 =23.672,P ＜ 0.05).The average day oral morphine dose of different types tumor were listed as followed from high to low in the order:160 (80,200) mg of metastatic tumors,120 (60,160) mg of breast and gynecological tumor,100 (40,125) mg of lung cancer,90(45,115) mg of urinary tract tumors,80(60,160) mg of other tumors,70(50,90) mg of hepatobiliary pancreatic tumor,60 (40,80) mg of gastrointestinal tumor,55 (40,70) mg of head and neck tumor.There were significant differences in terms of among oral morphine dose per day of different type tumors (H=14.280,P ＜0.05).No correlation was found between pain patients with height,body mass,body surface area and average daily dose of morphine (r =-0.045,-0.042,-0.046 ; P ＜ 0.05).Conclusion No significant differences were found in terms of moderate to severe cancer pain among different type tumors at different and age groups.While there is significant difference in term of cancer pain incidence among different tumor types.The average daily amount of morphine in patients with cancer pain is not related to gender,height,body mass and body surface area.The average amount of morphine of patients with age over 80 years old is significantly lower than that of the other age groups,and the average amount of morphine t is related to cancer type.