Effect of intrathecal dexmedetomidine on spinal morphine analgesia in patients
with refractory cancer pain.
Author(s): Liu HJ(1), Gao XZ, Liu XM, Xia M, Li WY, Jin Y.
Affiliation(s): Author information:
(1)Department of Anesthesiology, Jinling Hospital, Clinical School of Nanjing,
Second Military Medical University , Nanjing, Peoples Republic of China .
Publication date & source: 2014, J Palliat Med. , 17(7):837-40
BACKGROUND: Systemic administration of dexmedetomidine has been shown to reduce
opioid consumption and improve analgesia satisfaction. The purpose of this study
was to investigate the effect of intrathecal dexmedetomidine on spinal morphine
analgesia in patients with refractory cancer pain.
METHODS: A double-blinded crossover study was designed and performed. Patients
were randomly allocated in one of the two phases. Phase M received intrathecal
morphine administration. Phase M+D received intrathecal morphine plus
dexmedetomidine administration. All patients were monitored for 7 days and
crossed over to alternate phase for another 1-week observation. Daily average
visual analog scale (VAS) pain score, pain frequency, sleep deprivation, daily
morphine consumption, bolus dose injection times, and side effects were all
recorded.
RESULTS: Pain intensity and frequency were significantly decreased in both phases
compared with baseline. Daily morphine consumption and bolus dose injection times
during phase M+D were significantly decreased compared with phase M. The
incidences of constipation were significantly reduced in both phases compared
with baseline administration, but nausea and vomiting were significantly
increased. No serious side effects such as respiratory inhibition were observed
in this study.
CONCLUSIONS: Intrathecal administration of dexmedetomidine and morphine reduced
the morphine consumption in patients with refractory cancer pain. There were no
serious side effects.
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