中国口腔颌面外科杂志 ›› 2018, Vol. 16 ›› Issue (5): 431-435.doi: 10.19438/j.cjoms.2018.05.009

• 论著 • 上一篇    下一篇

丁丙诺啡透皮贴剂与芬太尼透皮贴剂用于口腔恶性肿瘤术后持续性疼痛的疗效和安全性比较

李梦雅, 孙宇*, 姜虹*   

  1. 上海交通大学医学院附属第九人民医院 麻醉科,上海 200011
  • 收稿日期:2018-06-28 出版日期:2018-09-20 发布日期:2018-11-06
  • 通讯作者: 孙宇,E-mail:dr_sunyu@163.com;姜虹,E-mail:dr_jianghong@163.com。共同通信作者
  • 作者简介:李梦雅(1988-),女,硕士研究生,住院医师,E-mail:1915929104@qq.com
  • 基金资助:
    上海市卫计委重要薄弱学科建设项目(2016ZB0203-01)

Efficacy and safety of transdermal buprenorphine versus transdermal fentanyl in patients with persistent postoperative pain after oral malignant tumor surgery

LI Meng-ya, SUN Yu, JIANG Hong   

  1. Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2018-06-28 Online:2018-09-20 Published:2018-11-06

摘要: 目的: 比较丁丙诺啡透皮贴剂与芬太尼透皮贴剂用于口腔恶性肿瘤术后持续性疼痛的疗效和安全性。方法: 根据计算机生成的随机列表,将患者随机分为丁丙诺啡透皮贴剂组(试验组)、芬太尼透皮贴剂组(对照组),每组各52例患者。比较2组患者使用前和使用后第1、3、5、7、14、21、28天的VAS疼痛评分、补救用药使用例数、不良反应发生率以及总体满意度。采用SPSS 23.0软件包对2组资料进行t检验、χ2检验和秩和检验,筛选差异指标。结果: 共纳入104例患者,实际完成96例,包括丁丙诺啡透皮贴剂组49例、芬太尼贴剂组47例。2组患者基线可比,使用贴剂前、后的VAS疼痛评分差异无统计学意义(P﹥0.05);2组追加盐酸曲马多的总例数无统计学意义(P﹥0.05),皮肤瘙痒、便秘发生率无统计学差异(P﹥0.05),试验组恶心、呕吐及嗜睡的发生率显著低于对照组(P﹤0.05),试验组患者满意度显著高于对照组(P﹤0.05)。结论: 丁丙诺啡透皮贴剂用于口腔恶性肿瘤患者术后持续性疼痛的镇痛效果与芬太尼贴剂相当,但其嗜睡、恶心、呕吐等不良反应少,使用方便,患者满意度高。

关键词: 丁丙诺啡透皮贴剂, 芬太尼透皮贴剂, 术后疼痛, 镇痛, 口腔恶性肿瘤

Abstract: PURPOSE: To compare the efficacy and safety of buprenorphine transdermal patch and fentanyl transdermal patch for postoperative persistent pain after oral malignant tumor surgery. METHODS: According to a computer-generated randomized list, the patients were randomly divided into buprenorphine transdermal patch group (experimental group) and fentanyl transdermal patch group (control group), 52 cases in each group. The differences in VAS pain scores, number of remediation drug, incidence of adverse reactions, and differences in overall satisfaction between the two groups before and after use were compared on days 1, 3, 5, 7, 14, 21, and 28. SPSS 23.0 software package was used for statistical analysis. RESULTS: A total of 104 cases were included, and 96 completed the study: 49 patients in the buprenorphine transdermal patch group and 47 in the fentanyl patch group. There was no significant difference in VAS pain score between the two groups before and after the use of patch (P>0.05); there was no significant difference between the two groups in the total number of tramadol hydrochloride (P>0.05). The incidence of constipation was not statistically significant (P>0.05). The incidence of nausea, vomiting and drowsiness was significantly lower in the experimental group than in the control group (P<0.05). The patients' satisfaction of the experimental group was significantly higher than that of the control group (P<0.05). CONCLUSIONS: Transdermal buprenorphine patch for oral cancer patients with persistent pain after analgesic effect is equivalent to fentanyl patch, but with less lethargy, nausea, vomiting and fewer other adverse reactions. It is easy to use, and the degree of patients' satisfaction is high.

Key words: Buprenorphine transdermal patch, Fentanyl transdermal patch, Postoperative pain, Analgesia, Oral malignant tumor

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