盐酸奈福泮在术后皮下自控镇痛中的应用

目的:评价盐酸奈福泮用于术后皮下自控镇痛(PCSA)的安全性及有效性。方法:210例腹部、四肢手术患者随机分为2组,均以电子镇痛泵行术后PCSA。对照组(F组,n=110):芬太尼0.8mg+生理盐水至60mL,背景量1mL·h-1,患者自控镇痛(PCA)1mL;观察组(N组,n=100):奈福泮80mg+生理盐水至100mL,背景量2～2.5mL·h-1,PCA2mL。均于术毕启动PCA泵,观察2组术后1、4、8、16、24hVAS评分和48h内总体镇痛满意度及不良反应。结果:2组各时间点VAS评分相仿(P>0.05),48h内总体镇痛满意度无显著性差异(P>0.05),恶心、呕吐、头晕、嗜睡发生率N组略低于F组,但无统计学意义(P>0.05),均无皮肤瘙痒和呼吸抑制。结论:等效剂量的盐酸奈福泮术后PCSA效应与芬太尼接近,副作用少,适用于术后PCSA。

Nefopam Hydrochloride for Postoperative Subcutaneous Patient Controlled Analgesia

OBJECTIVE:To evaluate the safety and effectiveness of Nefopam Hydrochloride for postoperative subcutaneous patient controlled analgesia.METHODS:A total of 210 patients undergoing abdomen or limbs surgery were randomly divided into two groups.All of whom were assigned to receive postoperative PCSA with electronic PCA pumps.Control group(F group,n=110):Fentanyl(0.8mg)was diluted with physiological saline to 60mL,in which,the background dose was 1mL·h-1 and PCA was at a dose of 1ml;Observation group(N group,n=100):Nefopam Hydrochloride(80mg)was diluted with physiological saline to 100mL,in which the background dose was 2～2.5mL·h-1,and PCA was at a dose of 2mL.The PCA pumps were started on all patients immediately after surgery,and the VAS scores at 1,4,8,16 and 24h and the total antalgic satisfaction degree within 48h after surgery were compared between two groups.RESULTS:The two groups were similar in VAS scores at each observing time(P>0.05),and there was no significant difference in the overall antalgic satisfaction degree within 48h between the two groups(P>0.05).Incidences of nausea,vomiting,dizziness and drowsiness were slightly lower in N group than in F group,but which was of no statistical significance(P>0.05).Neither pruritus nor respiratory depression was noted in both groups.CONCLUSION:At an equivalent dose,Nefopam Hydrochloride showed a similar PCSA efficacy to Fentanyl after surgery but less side effect,therefore,it can be applied in postoperative PCSA.