| Objective: The management of Breakthrough cancer pain(BTc P)is an important part of cancer pain management.Morphine hydrochloride tablets are commonly used in the treatment of BTc P,but its effect is relatively slow,which affects the treatment of BTc P.Oxycodone hydrochloride capsule is a new type of immediate release opioid in China,but there is little research on its application in the treatment of BTc P.Therefore,to explore the analgesic efficacy and safety of oxycodone hydrochloride capsule in the treatment of opioid tolerance cancer pain patients with BTc P relief,and to evaluate its effectiveness and adverse reactions,in order to provide a theoretical basis for the treatment of cancer pain patients with BTc P.Methods: According to the entry and discharge criteria determined in this study,opioid-tolerant cancer pain patients treated in the Affiliated Hospital of Qinghai University from November 2019 to December 2020 were collected and randomly divided into group A and group B by number table method.Patients in both groups were treated with sustained release opioids for basic pain control.When patients had outbursts of pain,group A was given morphine hydrochloride tablets,and group B was given oxycodone hydrochloride capsules at A dose of 10%-20% of the all-day background dose.Pain was assessed at 15 min,30min,45 min and 60 min after administration,respectively.After 1h of administration,if the NRS score was 4-6points,the release agent should be added 25%-50% on the original basis as appropriate;if the NRS score was ≥7 points,the release agent should be added 50%-100% on the original basis as appropriate;after 1h,it should be evaluated again with the same regimen and so on until the NRS score was ≤3 points.The background dose was adjusted every 24 hours based on the degree of pain relief or the number of pain outbreaks used during the previous day.If pain is not alleviated or relief medication is used more than 2 times,adjust the background dose to the original dose by 25% to50%,otherwise keep the original dose.For each patient,the number of outbursts for 3consecutive days was collected.The analgesic effect of drugs during the outbreak of pain,the quality of life level,satisfaction degree after 3 days of treatment and the toxic and side effects during treatment were compared between the two groups.Results:1.A total of 40 patients were enrolled in this study.There was no difference in tumor type,basic pain relief drugs,pain nature,gender,ECOG,age and basic NRS score between the two groups(P > 0.05).2.A total of 100 outbursts of pain for 3 consecutive days were collected from each patient,including 47 cases in the morphine hydrochloride tablet group and 53 cases in the oxycodone hydrochloride capsule group.Pain intensity(PI0)was7.36±1.05 in morphine hydrochloride tablets group and 7.21±1.02 in oxycodone hydrochloride capsules group,there was no difference(P>0.05).The pain intensity(PI30)was 4.96±0.10 in oxycodone hydrochloride capsule group and 5.46±0.11 in morphine hydrochloride tablet group at 30 min after administration,and the difference was significant(P < 0.05).3.The PID30 of oxycodone hydrochloride capsule group was 2.25±0.55,while that of morphine hydrochloride tablet group was 1.89±0.66,the difference was significant(P < 0.05).4.The pain relief rate of oxycodone hydrochloride capsule group and morphine hydrochloride tablet group was 90.56% and 89.56%,respectively,with no significant difference(P > 0.05).5.After treatment for 3 days two groups of patients satisfaction in a pain-killer effect time difference(P < 0.05),while in the related pain treatment time,the information,the doctor patient rounds to pain nursing,painkillers mode of delivery,the dosage of the drug use frequency,pain,pain duration and the pain-relieving effect of drugs and comprehensive satisfaction,pain control no statistical difference(P >0.05).6.Three days after treatment of morphine hydrochloride group and oxycodone hydrochloride capsules in nausea,constipation,skin itching,incidence of vomiting,dizziness,respectively,35%,80%,10%,15%,5% VS30%,50%,10%,10%,5%,oxycodone hydrochloride capsule treatment group 3 days constipation,lower than that of morphine hydrochloride group was significant difference(P < 0.05),more adverse reactions compared difference(P > 0.05).7.There was no difference in QOL between the two groups before administration(P > 0.05)(31.0±2.596 and 30.0±2.511,respectively),and there was no difference in QOL between the two groups after 3 days of treatment(P >0.05)(37.35±1.725 and 38.0±2.052,respectively).QOL between the two groups after treatment was improved compared with that before treatment,with statistical significance(P < 0.05).Conclusion:1.Oxycodone hydrochloride capsules and morphine hydrochloride tablets can be used to treat BTc P and reduce the level of pain.However,compared with morphine hydrochloride tablets,oxycodone hydrochloride capsules can significantly reduce the pain 30 minutes after administration,with relatively fast onset of analgesia and better patient satisfaction.2.Oxycodone hydrochloride capsules and morphine hydrochloride tablets can improve the quality of life,and patients’ satisfaction is similar,but compared with morphine hydrochloride tablets,oxycodone hydrochloride capsules has a lower incidence of constipation,which can bring benefits for the treatment of BTc P. |
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