Effects of controlledrelease morphine sulfate tablets combined with SGB on premortem symptoms,pain mediators,and breakthrough pain frequency in patients with moderate to severe cancer pain from advanced lung cancer
Xie Jianxin
Wang Shinan
Li Hongyu
Yang Ning
Chang Chen
Gao Chao
An Yang
Ma Chaolei
Zhang Liping
Abstract：Objective To investigate the effects of controlledrelease morphine sulfate tablets combined with stellate ganglion block(SGB)on premortem symptoms,serum pain mediators,and breakthrough pain frequency in patients with moderate to severe cancer pain from advanced lung cancer,aiming to provide evidence for alleviating pain and improving quality of life.Methods Clinical data were retrospectively collected for 110 patients with moderate to severe cancer pain from advanced lung cancer treated at Hebei Yanda Hospital from January 2021 to January 2024.Patients were assigned to a control group(n=48),receiving controlledrelease morphine sulfate tablets alone,or a combination group(n=62),receiving SGB plus controlle-drelease morphine.Functional status,Edmonton Symptom Assessment System(ESAS)scores,pain mediator levels[serum levels of substance P(SP)and prostaglandin E2(PGE2)],breakthrough pain frequency,morphine dosage,and adverse reac-tions were compared.Results Before treatment,ESAS dimension scores and Palliative Performance Scale(PPS)scores did not differ significantly between groups(P>0.05).After treatment,the combination group showed significantly lower ESAS scores across all dimensions except for the paresthesia dimension,and significantly higher PPS scores compared to both their own baseline and the control group(P<0.05).Baseline serum SP and PGE2 levels did not differ significantly between groups(P>0.05).With ongoing treatment,both groups experienced progressive declines in SP and PGE2,and posttreatment levels in the combination group were significantly lower than those in the control group at corresponding time points(P<0.05).The combination group also had significantly fewer breakthrough pain episodes and required lower total morphine doses than the control group(P<0.05).Adverse reaction rates during treatment were 52.08%(25/48)in the control group and 48.39%(30/62)in the combination group,with no significant difference(χ2=0.148,P=0.701).Conclusion In advanced lung cancer patients with moderate to severe cancer pain,compared with the administration of controlledrelease morphine sulfate tablets alone,adding SGB to the controlledrelease morphine sulfate tablets provides superior improvement in premortem symp-toms,greater reductions in pain mediator levels,and fewer breakthrough pain episodes,without increasing the risk of adverse reactions.
Keywords：Lung cancerCancer painControlledrelease morphine sulfate tabletsStellate ganglion blockPain mediators
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 50-56 )