盐酸奈福泮用于妇科腹腔镜术后镇痛的临床观察

Clinical Observation of Postoperative Analgesia for Patients Undergoing Gynaecological Laparoscopic Operations with Nefopam Hydrochloride

目的:评价盐酸奈福泮单次静脉注射用于妇科腹腔镜术后镇痛的有效性和安全性。方法:90例妇科腹腔镜手术患者,随机分为盐酸奈福泮组(Ⅰ组)、曲马多组(Ⅱ组)和对照组(Ⅲ组),Ⅰ组和Ⅱ组患者在麻醉诱导后手术开始前分别静脉注射盐酸奈福泮0.5mg/kg和曲马多2.5mg/kg,Ⅲ组则缓慢静脉注射生理盐水5ml。采用视觉模拟法(VAS评分)对患者术后1、2、4、8、24h痛觉评分,并记录有无寒战、恶心呕吐等不良反应及术后前24小时使用镇痛药的次数。结果:盐酸奈福泮组和曲马多组术后各时点的VAS评分及使用镇痛药的次数均低于对照组(P<0.05),术后寒战的发生率也低于对照组(P<0.05)。而盐酸奈福泮组恶心呕吐、头昏等副作用的发生率明显低于曲马多组(P<0.05)。结论:术前单次静脉注射盐酸奈福泮0.5mg/kg可有效缓解妇科腹腔镜术后疼痛,且副作用少于曲马多。

Objective： To assess the effectiveness and safety of postoperative analgesia from nefopam hydrochloride in patients undergoing gynaecologieal laparoseopie operations. Method： Ninety patients having gynaecological laparoseopie operations were randomly divided into three groups： nefopam hydrochloride group （ group Ⅰ ）, tramadol group （ group Ⅱ ） and eontrol group （ group m）. In group Ⅰ and groupⅡ , 0.5mg/kg nefopam hydrochloride or 2.5mg/kg tramadol was injected before operation. And group Ⅲ receivod 5ml normal saline. Postoperative pain was assessed by VAS - score at 1, 2, 4, 8, 24 hours after the surgery. Adverse effects sueh as el＇fills and nausea, and the ineidenee of analgesie injection was also recorded. Results： The patients in the nefopam hydrochloride group and tramadol group had signifieanfly lower VAS scores and lower ineidenees of analgesie injection than that of the eontrol group （P 〈 0.05 ）, and the ineidenee of postoperation chills in the two groups was also lower than the control group （ P 〈 0.05）. The ineidenee of side effects sueh as nausea and dizziness in nefopam hydrochloride group was lower the than that of tramadol group （P 〈 0.05）. Conclusion： Intravenous injection of Nefopam hydrochloride （0.5mg/kg） before the gynaecologieal laparoseopie operations eould provide satisfactory postoperative pain relief, and has fewer side effects than tramadol.