Objective:To analyze the efficacy and safety of intrathecal morphine infusion by subcutaneous port for the management of severe cancer pain retrospectively.Methods:Thirty patients undergone intrathecal morphine infusion by subcutaneous port for the management of severe cancer pain during October 2013 to March 2016 were included. Patient demographic data, duration of intrathecal administration of opioid, preoperative visual analogue scale (VAS) scores, doses of systemic opioids, VAS scores on the 1st, 3rd, 7th, 14th, 30th days post operation, dose of systemic opioids after procedure, doses of intrathecal morphine, side effects and complications. The relationship between the interval of initial pain to procedure and the time required to increase doses to a satisfactory level and doses of postoperative intrathecal morphine infusion were also evaluated.Results: The average survival time of patients was 10.8±21.6 months and the follow-up time was 5.7±8.1 months. The preoperative VAS score was 7.9±2.8 and the VAS scores on the postoperative 1st, 3rd, 7th, 14th, and 30th days were 5.6±2.5, 4.3±2.1, 3.3±2.0, 3.2±2.3, and 3.3±2.7, respectively, which were significantly lower than preoperative value. The systemic opioid consumption decreased significantly, while the intrathecal morphine consumption increased gradually. Nausea and vomiting were observed in 5 patients. Urinary retention appeared in 3 patients. Cerebrospinal fluid leakage was observed in 5 patients. The time required for increasing the intrathecal morphine to a satisfactory level in the patients whose interval of initial pain to procedure being beyond 1 month was 17.1±5.8 days and the morphine consumption of 24 hours was 4.4±2.1 mg. Both of them were significantly longer or higher than those with the interval of initial pain to procedure being less than 1 month.Conclusion: Intrathecal morphine infusion by subcutaneous port is an effective and safe method for the management of cancer pain.%目的：回顾性分析经皮下输注装置鞘内吗啡输注对晚期重度癌痛的有效性和安全性。方法：通过电子病历系统，调取2013年10月～2016年3月采用经皮下输注装置鞘内吗啡输注治疗的30例晚期重度癌痛患者的一般信息、持续鞘内输注吗啡时间、术前疼痛视觉模拟评分(visual analogue scale, VAS)评分、阿片类药物用量和术后第1、3、7、14、30天的VAS评分、非鞘内途径阿片类药物用量、鞘内吗啡用量、阿片副作用、并发症等情况进行分析，评价患者疼痛至手术的间隔时间与调控至满意剂量所需时间和术后吗啡输注剂量的关系。结果：患者术后生存期为10.8±21.6个月，随访时间5.7±8.1个月，术前VAS评分为7.9±2.8，术后第1、3、7、14、30天的VAS评分分别为5.6±2.5、4.3±2.1、3.3±2.0、3.2±2.3、3.3±2.7，明显低于术前基础值；术后非鞘内途径的阿片类药物用量显著下降，鞘内吗啡用量逐渐增加。有5例患者出现了恶心呕吐，3例患者出现了尿潴留，5例患者出现了脑脊液漏。疼痛至手术的间隔时间>1个月的患者，术后吗啡剂量调整至稳定剂量所耗费的时间为17.1±5.8天，24小时吗啡用量为4.4±2.1 mg，明显长（高）于疼痛至手术间隔时间<1个月的患者。结论：经皮下输注装置鞘内吗啡持续输注是治疗晚期重度癌痛的有效方法。
展开▼
