Epidural Treatment and Endocrine Response to Pain in Cancer Patients

癌症患者的硬膜外治疗和疼痛的内分泌反应

基本信息

批准号：
62480324
负责人：
OYAMA Tsutomu
金额：
$ 2.3万
依托单位：
University of Hirosaki School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1987
资助国家：
日本
起止时间：
1987 至 1988
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-62480324/
关键词：
continuous epidural infusion continuous epidural infusion pump cancer pain morphine buprenorphine 日内変動

项目摘要

We have applied morphine and buprenorphine by continuous epidural infusion with computerized ambulatory drug delivery-patient-controlled analgesia (CADD-PCA^<TM>) in cancer patients. We evaluated the efficacy and safety of CADD-PCA^<TM> and studied the effect of pain and pain relief on plasma levels of stress hormones.CADD-PCA@>D1TM@>D1 is a compuct pump of 8.9 x 16.0 x 2.3 cm, weighing 425g, for continuous and incremental infusion of analgesics. The basal rate is infused automatically, but incremental infusion programmed by a physician is controlled by the patient depending upon the magnitude of pain. In addition, the basal and incremental dose of analgesic can be self-controlled by a patient, although the maximum dose is limited by programming in advance by the physician.Morphine hcl by using CADD-PCA^<TM> was administered to 16 cancer patients and buprenorphine was used in 5 patients. No significant changes in blood pressure, heart rate or respiratory rate were observed in all patients. Neither mechanical trouble caused by CADD-PCA^<TM> pump nor complication except for slight dysuria and itching in morphine group was experienced. The device was proved to be safe and useful for epidural infusion of analgesics.To detect the influence of pain on the diurnal variation of plasma levels of cortisol and ACTH, the blood samples were obtained at 8:00, 12:00 ＆ 16:00 from the same patient before the treatment with CADD-PCA^<TM> and during the pain relief period. Plasma levels of cortisol before treatment fluctuated markedly. After the treatment the cortisol levels had a tendency of less variable, but we could not find any clear diurnal variation of cortisol and ACTH. It is thus suggested that psychological factor might participate in it, because diurnal variation of plasma levels of cortisol and ACTH was not influenced by the analgesic effect of continuous epidural infusion of morphine of buprenorphine in cancer patients.

我们通过在癌症患者中连续输注甲壳虫药物控制的镇痛作用（CADD-PCA^<TM>），应用了吗啡和丁丙诺啡。疼痛在应力的压力压力上的应力和镇压压力的压力减轻止痛药可以由患者进行自我控制，Althooth可以通过医生提前进行编程。MorphinehCl通过使用CADD-PCA^<Hminister for 16例癌症患者，并在5名患者中使用了丁丙诺啡。在所有患者中都观察到血压，心率或呼吸速度的GE。为了检测疼痛对皮质醇和ACTH血浆水平的影响，在疼痛的缓解期间，皮质醇的血浆水平显着治疗皮质醇的作用，不受连续输注吗啡吗啡在癌症中吗啡的镇痛作用的影响。