| Objectives: This study compared the pain relief effects of opioids combined with gabapentin and opioids alone after an outbreak of pain in patients with opioid-tolerant cancer pain to explore better cancer pain management;at the same time through opioids Application and clinical treatment of patients with pain,understanding of cancer diagnosis and treatment in the real world,exploring factors related to insufficient treatment of cancer pain,and promoting better pain management.Methods: Selected 60 patients suffering from malignant tumors with moderate or severe cancer pain from September 2016 to April 2017 in the Department of Oncology of the Fourth Hospital of Hebei Medical University.The patients were randomly divided into two groups when they experienced an outbreak of pain.,Oxycodone hydrochloride sustained-release tablets combined with gabapentin capsule group(B group)30 cases,only oxycodone hydrochloride sustained-release tablets group(A group)30 cases.The degree of pain relief before and after treatment,the consumption of oxycodone hydrochloride sustained-release tablets,quality of life scores and adverse reactions,and nighttime sleep time were compared between the two groups.At the same time,the consumption of opioids in inpatients in the Department of Oncology of the Fourth Hospital of Hebei Medical University from 2015 to2017 and 89 patients suffering from cancer pain from August 2017 to January2018 were recorded,and the general basic characteristics and analgesic treatment data were recorded.Analysis of the treatment status of cancer pain in our department.Results:1.NRS scores of both groups after treatment were lower than beforetreatment.The NRS scores after treatment in Group B were compared with those of Group A after treatment.There was a statistically significant difference(P<0.05).2.The quality score was higher than before,and the quality of life score in group B was higher than that in group A(P<0.05).3.The consumption of oxycodone hydrochloride sustained-release tablet in group B was lower than that in group A.There was statistical significance(P<0.05).4.The nighttime sleep time of both groups was higher than that before treatment.The nighttime sleep time of Group B was longer than that of Group A after treatment.The difference was statistically significant((P< 0.05).5.The main adverse reactions in both groups were constipation,nausea,vomiting and dizziness.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).6.From 2015 to 2017,the total consumption of three-tiered drugs in hospitalized patients in our department increased year by year.In 2016,it was2.39 times that of 2015,and in 2017 it was 1.31 times that of 2016.The consumption of second-tier drugs showed a declining trend year by year.7.76.4%(n=68)of 89 cases of cancer pain in our department were advanced malignant tumors.The most common type of cancer causing pain was lung cancer(43.8%),followed by gastrointestinal cancer(32.6%)and breast cancer(19.1%).8.88.8%(n=79)of the enrolled patients were treated with analgesics,and 30.8%(n=20)of them were treated with opioids and assisted sedative analgesia in patients with moderate to severe cancer pain.Patients with bone metastases were 61.8%(n=42)of all metastatic patients.All bone metastases were treated with bisphosphonate.9.The incidence of adverse reactions of opioids in the group was 30.1%(n=19),including 11 cases of constipation,6 cases of nausea,1 case of respiratory depression,and 1 case of urinary retention.10.Patients with moderate burst pain are mainly treated with oraladministration,and those with severe burst pain are mainly treated intravenously.Conclusions:1.Opioids combined with gabapentin are superior to opioids alone in the treatment of cancer pain with analgesic efficacy,improved quality of life,reduced opioid consumption,adverse drug reactions,and effective night time sleep.2.The total consumption of opioids in our department from 2015 to 2017 is increasing year by year.3.The proportion of moderate-to-severe cancer pain in patients with cancer pain in our department is relatively large;there are different degrees of outbreak pain and different ways of rescue treatment;in actual clinical work,there are still some patients with inadequate pain treatment and still need to strengthen cancer pain Standardized treatment. |
PDF Full Text Request