Zhou T J, Tang J, White P F
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Texas 75390-9068, USA.
Anesth Analg. 2001 Jun;92(6):1569-75. doi: 10.1097/00000539-200106000-00044.
We assessed the analgesic efficacy of IV propacetamol and ketorolac in a double-blinded, placebo-controlled study involving patients undergoing total hip or knee replacement procedures. On the first morning after major joint replacement surgery, 164 patients experiencing moderate-to-severe pain were randomly assigned to receive an IV infusion of propacetamol (2 g), ketorolac (15 or 30 mg), or placebo (saline). Patient-controlled analgesia with morphine was made available as a "rescue" analgesic on patient's request during the 6-h postdosing evaluation period. The median time to onset of analgesia with propacetamol (8 [95% confidence interval 6,10] min) was shorter than ketorolac 15 mg (14 [7,16] min), and placebo (16 [8; not estimable] min) although the differences did not reach statistical significance. However, compared with ketorolac 30 mg, propacetamol had a shorter duration of analgesia (3.5 [2;5.4] vs 6 [3.3; not estimable] h). Analysis of pain intensity and pain relief scores demonstrated that propacetamol produced a significantly greater improvement in pain relief than saline from 45 min until 5 h after the injection. Propacetamol was not significantly different from ketorolac 15 mg and 30 mg with respect to the main analgesic efficacy variables during the 6-h assessment period. The most frequently reported adverse event with propacetamol was injection site pain (28% vs 19% for ketorolac 15 mg, 29% for ketorolac 30 mg, and 10% for placebo, respectively). In conclusion, propacetamol (2 g IV) possesses a similar analgesic efficacy to ketorolac (15 or 30 mg IV) after total hip or knee replacement surgery.
在一项涉及接受全髋关节或膝关节置换手术患者的双盲、安慰剂对照研究中，我们评估了静脉注射丙帕他莫和酮咯酸的镇痛效果。在大关节置换手术后的第一个早晨，164名经历中重度疼痛的患者被随机分配接受静脉输注丙帕他莫（2g）、酮咯酸（15或30mg）或安慰剂（生理盐水）。在给药后6小时的评估期内，根据患者要求可使用吗啡自控镇痛作为“解救”镇痛药。丙帕他莫镇痛起效的中位时间（8[95%置信区间6,10]分钟）短于酮咯酸15mg（14[7,16]分钟）和安慰剂（16[8；不可估计]分钟），尽管差异未达到统计学意义。然而，与酮咯酸30mg相比，丙帕他莫的镇痛持续时间较短（3.5[2；5.4]小时对6[3.3；不可估计]小时）。疼痛强度和疼痛缓解评分分析表明，从注射后45分钟到5小时，丙帕他莫在疼痛缓解方面比生理盐水有显著更大的改善。在6小时评估期内，丙帕他莫在主要镇痛效果变量方面与酮咯酸15mg和30mg无显著差异。丙帕他莫最常报告的不良事件是注射部位疼痛（分别为28%，酮咯酸15mg为19%，酮咯酸30mg为29%，安慰剂为10%）。总之，全髋关节或膝关节置换手术后，丙帕他莫（静脉注射2g）与酮咯酸（静脉注射15或30mg）具有相似的镇痛效果。
