奈福泮复合舒芬太尼用于妇科手术后静脉镇痛的疗效观察

目的观察奈福泮复合舒芬太尼用于妇科手术患者术后静脉镇痛的临床效果及不良反应。方法60例ASAⅠ～Ⅱ级择期妇科手术患者，随机分为3组，每组20例。奈福泮组（N组）为奈福泮2mg·ml^-1；舒芬太尼组（S组）为舒芬太尼1．2μg·ml^-1；奈福泮复合舒芬太尼组（N＋S组）为奈福泮1mg·ml^-1与舒芬太尼0．6μg·ml^-1。三组均以生理盐水稀释到100ml，按2．0ml／h速度使用一次性镇痛泵经静脉持续镇痛48h。比较3组镇痛、镇静效果，以及不良反应。结果S组、N＋S组患者术后4h、8h、24h、48h镇痛效果优于N组，但N＋S组、N组术后恶心、呕吐等不良反应的发生率显著低于S组（P〈0．05或P〈0．01）。结论奈福泮复合舒芬太尼术后静脉镇痛是安全有效的，并且可以减少舒芬太尼的用量及其不良反应。

Nefopam combined with sufentanil for postoperative analgesia after gynecological surgery

Objective To evaluate the clinical efficacy of nefopam combined with sufentanil for postoperative analgesia after gynecological surgery. Methods Sixty ASA Ⅰ-Ⅱ patients underwent hysterectomy were randomly devided into three groups with 20 cases in each group. In group N, nefopam 2 mg·ml^-1 was added into the analgesic solution, in group S, sufentanil 1.2 μg·ml^-1 was used, and in group N＋S, nefopam 1 mg·ml^-1 plus sufentanil 0.6 μg·ml^-1 was used. Analgesic solution was diluted to 100 ml with normal saline in both groups. Analgesic solution was infused continuously in a dose of 2 ml/h for 48 h postoperatively. Visual analogue scale, sedation score and side effects were recorded. Results VAS in group S and group N＋S were significantly lower than that in group N at 4 h, 8 h, 24 h, 48 h after operation （P〈0.05 or P〈0.01）, but the occurrence of PONV were significantly less in group N＋ S and group N than those in group S （P〈0.05 or P〈0.01）. Conclusion Nefopam combined with sufentanil is effective and safe for postoperative intravenous analgesia with the advantages of reducing sufentanil requirement and its side effects.