Li Yan,Zhang Congzhi,Yin Shunhua,et al.Preliminary study of analgesic during infusion of GD2 monoclonal antibody naxitamab in children[J].Journal of Clinical Pediatric Surgery,,22():630-634.[doi:10.3760/cma.j.cn101785-202303043-006]
Preliminary study of analgesic during infusion of GD2 monoclonal antibody naxitamab in children
- Keywords:
- Antibodies; Monoclonal; Analgesia; Molecular Targeted Therapy; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the analgesic regimen of children during an infusion of GD2 monoclonal antibody naxitamab.Methods For this retrospective study, 167 naxitamab infusions were administered in 32 children with refractory neuroblastoma from August 2021 to February 2023 at Bo’ao Branch of Hainan Women & Children’s Medical Center.summarized the characteristics, location, duration and adverse reactions of pain caused by infusion.For relieving pain during infusion, a protocol with oral gabapentin as base analgesic was formulated with an intravenous infusion of potent compound analgesics.According to the uses of different analgesics, they were divided into three groups of fentanyl, esketamine and hydromorphone plus esketamine.The overall target was pain relief as judged by FLACC (Face, Legs, Activity, Cry, Consolability) ≤ 4 points.Results The number of occurrence of pain (FLACC score ≥ 4) during a single infusion in three groups was (3.17±1.23), (2.98±2.18) and (3.07±2.02) respectively.No statistically significant differences existed among three groups (F=0.413, P>0.05).The average time of a single infusion in three groups was (63.4±32.6), (59.7±45.6) and (64.6±48.9) min.No statistically significant differences existed among three groups (F=0.811, P>0.05).However, in the hydromorphone combined esketamine group, the dose of esketamine of mg/kg was significantly less than the dose in A group[(1.22±2.68) vs.(2.64±2.36), P<0.05].No significant difference existed in the incidence of major adverse reactions among three groups, such as low oxygen saturation[(28/51), (33/62) & (26/45), χ2=0.462, P>0.05].The number of cases of low mean arterial pressure was[(36/51), (39/62) & (23/45) (χ2=0.689, P>0.05)].Conclusion Oral gabapentin as a basic analgesic plus an intravenous infusion of fentanyl or esketamine are both safe and effective for pain bouts due to an infusion of naxitamab.And a combination of hydromorphone and esketamine can also achieve excellent analgesia.
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Memo
收稿日期:2023-03-15。
基金项目:海南省临床医学中心建设项目资助（琼卫医函, 2021]75号）
通讯作者:李艳,Email:xh52ly@126.com