Clinical application of dexmedetomidine combined with morphine in treatment of intractable cancer pain

Abstract

Objective To explore the effect of dexmedetomidine combined with morphine in intractable cancer pain with patient-controlled intravenous analgesia (PCIA).Methods Forty patients with intractable cancer pain were divided into experiment group and control group by random digits table method with 40 cases each.Composition of experiment group:morphine 200 mg + dexmedetomidine 1.0 mg + ondansetron 16 mg + 0.9％ sodium chloride.Composition of control group:morphine 200 mg+ ondansetron 16 mg + 0.9％ sodium chloride.Both analgesic fluid volume were 200 ml.The patients in experiment group were administrated 10 min with 0.5 μg/kg dexmedetomidine then received PCIA,the patients in control group were administrated 10 rmin with equal 0.9％ sodium chloride then received PCIA.The visual analogue scale (VAS) score was recorded 2 h before administration and 2,4,8,16,32,48 h after administration.Ramsay sedation score was recorded at all the time points after administration.The press number of patient-controlled analgesia pump and dosage of morphine in 48 h after administration,incidence of side effects (low pressure,bradycardia,respiratory inhibition,nausea and vomiting) were recorded.Results Compared with 2 h before administration,the VAS score was significantly lower at every time point after administration in the 2 groups,there was statistical difference (P ＜ 0.01).The Ramsay sedation score at every time point after administration in experiment group was significantly higher than that in control group,the press number of patient-controlled analgesia pump in 48 h was significantly lower than that in control group [(4.5 ± 2.2) times vs.(18.4 ± 5.4) times],dosage of morphine was significantly lower than that in control group [(90.8 ±7.2) mg vs.(100.5 ± 10.5) mg,the incidence of nausea and vomiting was significantly lower than that in control group,there were statistical differences (P ＜ 0.01).However,there were no significant differences in the incidence of respiratory depression and low pressure between the 2 groups (P ＞ 0.05).Conclusion Dexmedetomidine combined with morphine in the treatment of intractable cancer pain can effectively improve the analgesic effect and sedative effect,reduce the dosage of morphine. Key words: Dexmedetomidine; Morphine; Analgesia,patient-controlled; Pain,intractable