McLintock T T, Kenny G N, Howie J C, McArdle C S, Lawrie S, Aitken H
Department of Anaesthesia, Victoria Infirmary, Glasgow, UK.
Br J Surg. 1988 Aug;75(8):779-81. doi: 10.1002/bjs.1800750818.
A randomized, double-blind, placebo-controlled study was performed to assess the analgesic efficacy of intramuscular nefopam hydrochloride after upper abdominal surgery. Patients received either 20 mg nefopam (n = 23) or matching placebo (n = 26), 90 min before surgery, immediately after surgery, and 6, 12 and 18 h after the end of surgery. The 24-h morphine requirements were measured using a patient-controlled analgesia system delivering on-demand intravenous bolus doses of morphine. Pain was assessed using visual analogue scales. Patients receiving nefopam had a mean (+/- s.e.m.) cumulative morphine consumption of 4.1 +/- 0.8 mg in the first hour, compared with 8.5 +/- 0.8 mg in the control group (P less than 0.01). After 24 h the consumptions were 44.1 +/- 7.2 mg and 62.5 +/- 6.9 mg respectively (P less than 0.05). The pain scores in both groups were similar. This study confirms that nefopam hydrochloride has significant analgesic effects and would be a useful supplement to morphine in the management of postoperative pain.
进行了一项随机、双盲、安慰剂对照研究，以评估上腹部手术后肌内注射盐酸奈福泮的镇痛效果。患者在手术前90分钟、手术后即刻以及手术结束后6、12和18小时，分别接受20毫克奈福泮（n = 23）或匹配的安慰剂（n = 26）。使用患者自控镇痛系统按需静脉推注吗啡来测量24小时吗啡需求量。使用视觉模拟量表评估疼痛程度。接受奈福泮的患者在第一小时的平均（±标准误）累积吗啡消耗量为4.1±0.8毫克，而对照组为8.5±0.8毫克（P<0.01）。24小时后，消耗量分别为44.1±7.2毫克和62.5±6.9毫克（P<0.05）。两组的疼痛评分相似。本研究证实盐酸奈福泮具有显著的镇痛作用，在术后疼痛管理中可作为吗啡的有用补充。
