Observation of efficacy on self-controlled intrathecal morphine delivery system in patients with bone metastasis cancer pain of lung cancer

Abstract:

Objective：To investigate the feasibility of using patient controlled analgesia（PCA） combined with intrathecal drug delivery system（IDDS） in patients with bone metastasis cancer pain. Methods：From November 2017 to November 2018，patients with bone metastasis cancer pain in our department were included. Thirty patients were selected in accordance with inclusive criteria and ran－domly divided into two groups according to random digits table. Observation group：IDDS was implanted and PCA was externally con－nected；morphine was continuously injected，with speed（mL/h）= daily initial dose（mg）/（concentration*24），not lower than 0.1 mL/h. Control group：oral morphine sustained release tablets were mainly used and morphine injection was subcutaneously injected to con－trol breakthrough pain. The numerical rating scale（NRS） score，the daily morphine dose and the salivary α-amylase（SAA） activity were recorded before treatment（T1），three days after treatment（T2），and one week after treatment（T3） were recorded，and adverse reaction of two kinds of analgesia were observed. Results：According to repeated measurement，NRS and SAA activity were gradually decreased with the progress of treatment，and daily morphine dosage in the observation group was gradually decreased，with significant difference between the two adjacent time points（P<0.05），and with significant difference between different treatment methods（P<0.05）. Usage of intrathecal sustained medication had fewer adverse reactions（P<0.01）. Conclusion：Compared with oral morphine，IDDS combined with PCA can make bone metastasis cancer pain alleviate more rapidly to a greater extent，which can significantly improve patients’ anxiety and stress. In addition，the dosage of morphine is small and the adverse reaction is less.