Original Article
Comparing the efficacy of port and pump intrathecal infusion system on refractory cancer pain
Xu Xiaohui, Xu Lizhu, Yu Yang, Sun Mingjie, Shi fei, Chen Fuqiang
Published 2022-10-25
Cite as Chin J Painol, 2022, 18(5): 643-650. DOI: 10.3760/cma.j.cn101658-20220525-00083
Abstract
ObjectiveTo compare the clinical efficacy of semi-implantable port and totally implantable pump under the guidance of DSA on refractory cancer pain.
MethodsForty patients with refractory abdominal cancer pain in the Painology Department of the East Hospital of Qingdao Municipal Hospital, from January 2019 to January 2022, were collected and divided into semi-implantable infusion port group and totally implantable pump group, with 20 cases in each group. The patients were treated with standardized three-ladder treatment, but the pain was still poorly controlled or the adverse reactions intolerant, and the daily oral morphine dose was greater than 200 mg in both groups. Numerical rating scale (NRS), the MOS 36-item short-form health survey (SF-36), total intrathecal daily morphine dose and adverse incidence were recorded before (T0) and 1 day (T1), 3 days (T2), 7 days (T3), 1 month (T4) and 2 months (T5) after the intrathecal treatment.
ResultsThe daily morphine dose was not significantly different (about 3 mg/d) at T0, T1, T2, and T3 time points between the two groups. The daily morphine dose was significantly higher in the semi-implantable port group (15.4±3.1 and 23.3±5.5) mg/d than that in the totally implantable pump group (9.9±2.6 and 12.5±2.5) mg/d at T4 and T5 time points (P<0.05). The SF-36 scores were not significantly different at T0, T1, T2, and T3 time points between the two groups. The SF-36 score was significantly lower in the semi-implantable port group than that in the totally implantable pump group at T4 and T5 time points (P<0.05). NRS are comparable at each time point in the two groups. Postoperative complications were higher in the semi-implantable port group than that in the totally implantable pump group.
ConclusionBoth the semi-implantable port and the totally implantable pump methods can significantly alleviate refractory cancer pain, but for longer term treatment, the totally implantable pump method has more advantage, with significantly lower daily morphine consumption and higher quality of life.
Key words:
Cancer pain; Intrathecal infusion system; Infusion port; Totally implantable access port
Contributor Information
Xu Xiaohui
Department of Painology, Qingdao Muninicipal Hospital, Qingdao City, Shandong Province 266011, China
Department of Anesthesiology, Laizhou Hospital of Traditional Chinese Medicine, Yantai City, Shandong Province 261400, China
Xu Lizhu
Department of Medical Administration, Qingdao Muninicipal Hospital, Qingdao City, Shandong Province 266011, China
Yu Yang
Department of Painology, Qingdao Muninicipal Hospital, Qingdao City, Shandong Province 266011, China
Sun Mingjie
Department of Painology, Qingdao Muninicipal Hospital, Qingdao City, Shandong Province 266011, China
Shi fei
Department of Painology, Qingdao Muninicipal Hospital, Qingdao City, Shandong Province 266011, China
Chen Fuqiang
Department of Painology, Qingdao Muninicipal Hospital, Qingdao City, Shandong Province 266011, China
