舒芬太尼持续泵入联合自控镇痛治疗5例晚期难治性癌痛的临床观察

Objective To explore the clinical efficacy, safety and application value of continuous sufentanil infusion via peripherally inserted central catheter(PICC) combined with patient-controlled analgesia(PCA) in the management of advanced refractory cancer pain. Methods A total of 5 patients with advanced refractory cancer pain who had undergone PICC implantation were enrolled in this study. All patients received continuous sufentanil infusion via PICC plus PCA. The numerical rating scale(NRS) score, Ramsay sedation score, incidence and severity of breakthrough pain, quality of life(KPS score) and adverse drug reactions(ADRs) were observed before and after treatment. Results After one week and two weeks of treatment, the NRS scores of the patients were significantly lower than those before the treatment, and the difference was statistically significant(P<0.05). The Ramsay sedation scores were maintained at 2～3 points(quiet and cooperative or drowsy but responsive to instructions). The incidence and severity of breakthrough pain were remarkably reduced, from an average of(3.2±0.7) times/day before treatment to(0.2±0.4) times/day. The KPS scores of patients increased from(40.0±8.2) points before treatment to(70.0±7.1) points, with improved diet, sleep and mental status, and enhanced quality of life. The main adverse reactions were mild nausea(40%) and drowsiness(40%), which occurred in the early stage of treatment and relieved spontaneously. No severe ADRs such as respiratory depression or addiction tendency were observed, all of which were well controllable. Conclusion Continuous sufentanil infusion via PICC combined with PCA achieves definite analgesic effect in the treatment of advanced refractory cancer pain. It can effectively reduce breakthrough pain and improve quality of life of patients and has good economic benefits.