Clinical efficacy comparison between hydromorphone and morphine subcutaneous injection analgesia for cancer outbreak pain / 肿瘤研究与临床

ABSTRACT

Objective:To explore the clinical effects and adverse reactions of hydromorphone versus morphine subcutaneous injection analgesia for cancer outbreak pain.Methods:A total of 98 patients with cancer outbreak pain admitted to Xuzhou Central Hospital were selected. According to the random number table method, the patients were divided into the observation group (receiving subcutaneous injection of hydromorphone for analgesia) and the control group (receiving subcutaneous injection of morphine for analgesia), 49 cases in each group. The numerical rating scale (NRS) scores and quality of life (QOL) scores, pain relief effects, serum β-endorphin, substance P, 5-hydroxytryptamine levels and the incidence of adverse reactions were compared between the two groups.Results:The NRS scores of the two groups after treatment were decreased compared with those before treatment (all P < 0.05); and the NRS score of the observation group was lower than that of the control group after treatment [(2.4±0.4) scores vs. (3.2±0.5) scores, t = 8.69, P < 0.001]; the QOL scores of the two groups after treatment were higher than those before treatment (all P < 0.05); and there were no statistically significant difference in QOL scores after treatment between the two groups [(46±7) scores vs. (43±7) scores, t = 1.62, P = 0.109]. The total effective rate of pain relief of the observation group was higher than that of the control group [93.88% (46/49) vs.79.59% (39/49), χ2 = 4.35, P = 0.037]. The serum β-endorphin, substance P, 5-hydroxytryptamine levels of the two groups after treatment were decreased compared with those before treatment (all P < 0.05). β-endorphin, substance P and 5-hydroxytryptamine of the observation group were lower than those of the control group after treatment[β-endorphin (85±15) ng/L vs. (98±17) ng/L, substance P (2.1±0.3) μg/ml vs. (2.4±0.4) μg/ml, 5-hydroxytryptamine (0.31±0.05) ng/L vs.(0.38±0.06) ng/L; t values were 3.75, 3.63, 6.27, all P < 0.05). Compared with the control group, the incidence of adverse reactions like skin pruritus, nausea and vomiting of the observation group were lower (all P < 0.05). Conclusions:Compared with subcutaneous injection of morphine for analgesia, hydromorphone can better alleviate the pain of patients with cancer outbreak pain, decrease the level of pain mediators, and reduce the incidence of skin pruritus, nausea and vomiting.