Original Article
Effects of different doses of intrathecal dexmedetomidine combined with morphine analgesia in patients with advanced malignant tumor
Huaiqi Zhang, He Li, Jiwen Liu, Weidong Han, Congcai Ren, Ziliang Qian
Published 2017-12-25
Cite as Pain Clin J, 2017, 13(6): 425-430. DOI: 10.3760/cma.j.issn.1672-9633.2017.06.008
Abstract
ObjectiveTo study the effects of different doses of intrathecal dexmedetomidine (Dex) combined with morphine analgesia in the treatment of patients with advanced malignant tumor.
MethodsEighty patients with advanced malignant tumor were randomly divided into 4 groups, 20 cases in each group. All patients were intrathecally implanted with permanent analgesic pump. The patients received intrathecal injection of morphine in group A, 1.0 μg/ml Dex combined with morphine in group B, 1.5 μg/ml Dex combined with morphine in group C, and 2.0 μg/ml Dex combined with morphine in group D. VAS, satisfaction level, morphine doses, quality of life score and adverse reactions were observed and compared.
ResultsVAS was lower in group B、C、D than that in group A at 6, 12, 24, 48, 72 h after implantation of analgesic pump (P<0.05), but no significant difference among group B, C and D. Ramsay score was higher in group C and D than that in group A and B at 6, 12, 24, 48, 72 h after implantation of analgesic pump (P<0.05), but no significant difference between group C and D. The quality of life score was higher in group C and D than that in group A (P<0.05), but no significant difference between group C and D. The satisfaction level was highest in group C. The total amount of morphine within 72 h was significantly lower in group B, C and D than that in group A (P<0.05), and significantly lower in group C and D than that in group B, but no significant difference between group C and D. The incidence of constipation, vomiting and nausea decreased significantly after intrathecal administration of Dex, but the incidence of lethargy, hypotension and bradycardia increased significantly in group D, but no significant difference in the incidence of other adverse reactions.
ConclusionsContinuously intrathecal injection of 1.5 μg/ml dexmedetomidine combined with morphine can effectively reduce the dosage of morphine, enhance morphine analgesic effect, patient's satisfaction and quality of life in patients with cancer pain, without serious adverse reactions.
Key words:
Dexmedetomidine; Morphine; Intrathecal injection; Cancer pain
Contributor Information
Huaiqi Zhang
Department of Pain Medicine, Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen City 518000, China
He Li
Jiwen Liu
Weidong Han
Congcai Ren
Ziliang Qian
