奈福泮用于食管癌根治术后自控镇痛的效果

目的评估奈福泮(Nefopam)用于食管癌术后患者静脉自控镇痛(Patient-controlled intravenous analgesia,PCIA)的效果及其安全性。方法40例食管癌根治术后患者,随机分为2组,每组20例。分别为奈福泮组(N组)和吗啡组(M组),接受PCIA。N组:奈福泮120mg;M组:吗啡40mg。每组都加入地塞米松10mg、胃复安20mg,生理盐水稀释至100ml。应用英国Graseby-9300便携式PCA输液泵,其内设置和控制的参数:全部采用负荷剂量+持续输注+人自控(LCP)模式,设置负荷量4ml;持续剂量为2ml/h;锁定时间为10min;PCA剂量为0.5ml。结果N组与M组的镇痛效果VAS评分分别为2.1±0.6和2.0±0.7,组间比较无显著性差异。PCA总按压次数/实进数(D/D),N组与M组比较无显著性差异(P≥0.05)。镇静评分(SS),不良反应的发生率N组明显低于M组,其中以恶心的发生率降低最为明显(P≤0.01)。结论奈福泮用于食管癌术后PCIA,其镇痛效果与吗啡相似,不良反应明显低于吗啡,利于患者术后恢复。

Comparative study on patient-controlled intravenous analgesia with nefopam or with morphine after operation

Objective To compare the analgesic efficacy and safety of patient-controlled intravenous analgesia(PCIA) with nefopam or with mrophine in the patients following the surgery for cancer of esophagus.Methods Forty patients underwent resection of esophageal cancer surgery were randomly into nefopam group(group N,n=20) and morphine group(group M,n=20). The basic liquid contained dexamethasone 10mg and metoclopramide 20mg in 100ml 0.9% sodium chloride injection.Group N took basic liquid plus nefopam 0.9mg;Group M,basic liquid plus morphine 40mg.The two group's analgesia efficacy and side effect were compared respectively.Result There were no significant difference of the analgesia efficacy between the group N and group M(the VAS are 2.1±0.6 and 2.0±0.7 respectively).The adverse reaction of group N was lower than that of group M,especially the ratio of nausea(P≤0.01). Conclusion The adverse reacton of morphine are higher than that of nefopam under the same conditions.The analgesia efficacy of nefopam equal to that of morphin.