Pain assessment during conscious sedation for cervical cancer high-dose-rate brachytherapy
Pain assessment during conscious sedation for cervical cancer high-dose-rate brachytherapy
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DOI：
10.3747/co.20.1404
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发表时间：
2013-08-01
期刊：
影响因子：
2.6
通讯作者：
Lowry, S.
中科院分区：
文献类型：
--
作者：
Bhanabhai, H.;Samant, R.;Lowry, S.
BackgroundThis观察性研究旨在评估清醒镇静麻醉在高剂量率（HDR）近距离放射治疗过程中疼痛控制的有效性，使用环和串联喷头系统为宫颈癌patients with cervical cancer.MethodsAt的HDR宫颈癌近距离放射治疗计划在我们的机构启动时，患者在程序中接受了详细的症状评估。近距离放射治疗使用Smit套管和环形串联施源器进行。咪达唑仑和阿片类药物，氢吗啡酮，吗啡，或芬太尼的主要代理人，用于实现清醒seasoning.ResultsFrom 2009年1月至2010年10月，20例（中位年龄：45岁）进行了57个程序。所有患者均接受了具有治愈目的的放化疗。手术的中位持续时间为1.4小时，未观察到显著的心血管事件。使用的静脉咪达唑仑总剂量范围为0.5 mg至8.5 mg（中位数：2.5 mg）。使用的静脉内吗啡当量的总剂量范围为2.5 mg至60 mg（中位数：8 mg）。手术期间的平均和中位疼痛评分分别为1.4和1.1。在手术过程中发生某些事件时，特别是在插入环形串联施源器期间，观察到短暂的中度至重度偶发疼痛。整个手术期间的最大疼痛评分范围为0 - 10（中位数：4.7）。清醒镇静的恢复期相对较短（中位出院时间：1小时）。ConclusionsWe能够证明，接受HDR近距离放射治疗的宫颈癌患者可以实现良好的疼痛控制与清醒镇静。
BackgroundThis observational study set out to evaluate the effectiveness of conscious sedation anesthesia for pain control during high-dose-rate (HDR) brachytherapy using a ring-and-tandem applicator system for patients with cervical cancer.MethodsAt the time of initiation of the HDR cervical cancer brachytherapy program at our institution, patients received a detailed symptom assessment during the procedures. Brachytherapy was carried out using a Smit sleeve, together with a ring-and-tandem applicator. Midazolam and an opioid-hydromorphone, morphine, or fentanyl-were the main agents used to achieve conscious sedation.ResultsFrom January 2009 to October 2010, 20 patients (median age: 45 years) underwent 57 procedures. All patients received chemoradiation with curative intent. The median duration of the procedures was 1.4 hours, and no significant cardiovascular events were noted. The total dose of intravenous midazolam used ranged from 0.5 mg to 8.5 mg (median: 2.5 mg). The total dose of intravenous morphine equivalent used ranged from 2.5 mg to 60 mg (median: 8 mg). The mean and median pain scores during the procedures were 1.4 and 1.1 respectively. Brief moments of moderate to severe incidental pain were noted at the time of certain events during the procedure-specifically during insertion of the ring-and-tandem applicator. The maximal pain score during the entire procedure ranged from 0 to 10 (median: 4.7). The period of recovery from conscious sedation was relatively brief (median discharge time: 1 hour).ConclusionsWe were able to demonstrate that patients undergoing HDR brachytherapy for cervical cancer can achieve good pain control with conscious sedation.