| Project/Area Number |
62480324
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
麻酔学
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| Research Institution | University of Hirosaki School of Medicine |
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Principal Investigator |
OYAMA Tsutomu University of Hirosaki School of Medicine, Professor, 医学部, 教授 (60003349)
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| Co-Investigator(Kenkyū-buntansha) |
KUDO Mihoko University of Hirosaki School of Medicine, Assistant, 医学部, 助手 (30003411)
KUDO Tsuyoshi University of Hirosaki School of Medicine, Assistant, 医学部, 助手 (70003407)
MATSUKI Akitomo University of Hirosaki School of Medicine, Assistant Professof, 医学部, 助教授 (20003543)
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| Project Period (FY) |
1987 – 1988
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| Project Status |
Completed (Fiscal Year 1988)
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| Budget Amount *help |
¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 1988: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1987: ¥2,600,000 (Direct Cost: ¥2,600,000)
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| Keywords | continuous epidural infusion / continuous epidural infusion pump / cancer pain / morphine / buprenorphine / 日内変動 |
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| Research Abstract |
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.
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