Eremenko A A, Sorokina L S, Pavlov M V
Anesteziol Reanimatol. 2013 Mar-Apr(2):78-82.
A prospective, randomized, comparative study was conducted. 3 analgesia protocols were used: 1) patient controlled analgesia (PCA) with trimeperidine in combination with a nefopam constant infusion; 2) PCA with trimeperidine in combination with a nefopam bolus; 3) PCA with trimeperidine separately during early postoperative period in cardiac surgery patients. The study included 60 patients agedf rom 40 to 65 years of age (20 patients in each group). The analgesia efficacy was evaluated with a 5-point verbal rating scale (VRS) for pain intensity and inspiratory lung capacity (ILC), measured with incentive spirometer. The safety of nefopam during early postoperative period in cardiac surgery patients was shown. The combination of nefopam and trimeperidine led to a more pronounced analgetic effect. Trimeperidine consumption was significantly lower in nefopam groups than in the group of isolated PCA. Wholly adverse effects were associated with trimeperidine and were dose-related The incidence of nausea, vomiting, dizziness, weakness, bowel paresis was significantly higher in isolated PCA group than in the other two groups.
进行了一项前瞻性、随机、对照研究。采用了3种镇痛方案:1)哌替啶患者自控镇痛(PCA)联合奈福泮持续输注;2)哌替啶PCA联合奈福泮推注;3)心脏手术患者术后早期单独使用哌替啶PCA。该研究纳入了60例年龄在40至65岁之间的患者(每组20例)。采用5分言语疼痛评分量表(VRS)评估疼痛强度,并使用激励肺活量计测量吸气肺容量(ILC)来评价镇痛效果。结果表明了奈福泮在心脏手术患者术后早期的安全性。奈福泮与哌替啶联合使用产生了更显著的镇痛效果。奈福泮组的哌替啶消耗量显著低于单独使用PCA的组。所有不良反应均与哌替啶有关,且与剂量相关。单独使用PCA组的恶心、呕吐、头晕、虚弱、肠道麻痹发生率显著高于其他两组。