A Clinical Research Of Oxycodone Instead Of Morphine To Relieve The Resistance Of Cancer Patients To Opiates

Opioids are an important class of analgesic drugs, by simulating the role of endogenous opioid peptides in the analgesic effect of opioid receptors, opioid receptors are present inμ-,к-andδ- opioid receptors, whereμ-receptor most closely with the pain, emotion can playμ1 -receptor analgesia (spinal or above) the role of euphoria and drug dependence; excitedμ2 -receptors may be nausea, vomiting, constipation, respiratory depression and other reactions, excitedк-receptor produced analgesia (spinal cord) and sedation; excitedδ- receptor, resulting in pain, blood pressure, euphoria, miosis and so on. Morphine as the preferred first-line pain of moderate to severe cancer pain is widely used in clinical medicine, but clinical practice with patients on morphine drug resistance and need to constantly increase the dose, some patients feel fear because of dose arising rapidly, At the same time the increase in side effects as the dose increased gradually; Oxycodone is different from another opioid analgesics morphine, basic experiments have confirmed that oxycodone major role in theкreceptor small ofμ- receptor, which is the main role of morphine in theμreceptor is significantly different. Can morphine to oxycodone by the conversion to reduce cancer pain patients on opioid drug resistance still need to be further confirmed by clinical studies. 『Objective』:Observed by replacing morphine oxycodone cancer pain control, can reduce cancer patients resistant to opioids. METHODS: A prospective self-controlled experimental design. With (1.5:1) as the patients in each group to oxycodone morphine base conversion rate, with the digital grading score (Numeral Rating Scale ,NRS), Digital Status Scale score (Karnofsky Performance Status ,KPS), quality of life scores (Quality of Life ,QOL) before and after the analgesic effect as the conversion , mobility and quality of life index『Methods』:Between january 2009 and july 2010,85 patients were enrolled frome the Hospice of the First Affiliated Hospital of Guangxi Medical University, who were met the inclusion criteria. Taking a prospective self-control experiments, according to the actual patient dose of morphine required for pain patients were divided into five groups, that A group 12 patients( <60mg), B group 19 patients(60mg ~ 119mg), C group 24 patients( 120mg ~ 179mg), D group17patients (180mg ~ 240mg), E group 13 patients(> 240mg), taking (1.5:1) as the base conversion rate of (morphine/oxycodone) in each group patients and take the NRS score, QOL score and KPS score as the assessment indicator of analgesic effect, quality life skills and life skills before and after the conversion. The data were analyzed by SPSS13.0 software: Using analysis of variance to compare the five groups difference before and after conversion of (morphine / oxycodone )between the average ratio, and the trend test with the mean ratio in each group were verified whether the number was a linear trend; Using t test to compare the patients'scores of NRS,QOL,KPS before and after the conversion, Using rank test to compare all patients'medication compliance of the two drugs before and after the conversion,. Describing and count the adverse reactions before and after the conversion.『Result』:1.With the increase of morphine dosage , the mean ratio of (morphine/oxycodone) growing up, moreover,the ratio and the morphine dosage showing linear trend (F = 0.003, P = 0.954>0.05).2.The scores of NRS and QOL of patients have no significant different before and after conversion (P >0.05), before conversion,the KPS score was higher (P <0.05).3.The main side effects of the two drugs are dizziness, constipation, nausea, dysuria, skin itching and so on.『Conclusions』:Used instead of morphine oxycodone can obtain considerable analgesic effect of morphine, and switching to high-dose morphine oxycodone oxycodone after the actual requirements than small doses of morphine for oxycodone use of oxycodone after the needs of amount is smaller, that is, when a patient appears resistant receptor on morphine required after increasing doses of oxycodone for use may be a reduction of opioid consumption, reducing resistance to new ways of opioid.