Effectiveness of rapid titration with intravenous administration of oxycodone injection in advanced cancer patients with severe pain
Effectiveness of rapid titration with intravenous administration of oxycodone injection in advanced cancer patients with severe pain
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DOI：
10.1093/jjco/hyz145
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发表时间：
2019-11-01
影响因子：
2.4
通讯作者：
Nakajima, Nobuhisa
中科院分区：
文献类型：
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作者：
Nakajima, Nobuhisa
一些癌症患者突然出现严重的，难以忍受的疼痛，需要使用阿片类药物进行快速管理。本研究旨在评价羟考酮注射液快速滴定的有效性。研究对象是经历重度疼痛（数字评定量表>= 7）并且需要迅速缓解疼痛的晚期癌症患者。主要终点是（i）显著镇痛的初始体征变得明显所需的时间。次要终点为（ii）疼痛缓解稳定成功率和（iii）不良反应。对羟考酮（羟考酮组）和吗啡（吗啡组）治疗组进行回顾性比较。羟考酮组33例，吗啡组32例：（i）羟考酮组15.6 +/- 4.3 min，吗啡组19.3 +/- 4.7 min（P = 0.001）;羟考酮组和吗啡组24小时内分别为70%和63%，48小时内分别为88%和84%（P = 0.36，0.48）。虽然（iii）两组都出现了呼吸抑制等形式的不良反应，影响轻微。使用羟考酮注射剂进行快速滴定可能是一种有益的选择。
Some cancer patients suddenly develop severe, excruciating pain that requires rapid management using opioid medication. This study aimed to evaluate the effectiveness of rapid titration using oxycodone injection. Study subjects were advanced cancer patients who experienced severe pain (numeric rating scale >= 7) and needed prompt pain relief. Primary endpoint was (i) time required for the initial sign of significant analgesia to become evident. Secondary endpoints were (ii) pain relief stabilization success rate and (iii) adverse effects. Groups treated with oxycodone (oxycodone group) and morphine (morphine group) were retrospectively compared. The oxycodone group had 33 cases and the morphine group had 32 cases: (i) 15.6 +/- 4.3 min in the oxycodone group and 19.3 +/- 4.7 min in the morphine group (P = 0.001); (ii) 70 and 63% within 24 hours, and 88 and 84% within 48 hours in the oxycodone group and the morphine group, respectively (P = 0.36, 0.48). Although (iii) adverse effects appeared in both groups in the form of respiratory suppression, etc., the effects were mild. Rapid titration using oxycodone injections may be considered a beneficial choice.