Kostamovaara P A, Laitinen J O, Nuutinen L S, Koivuranta M K
Department of Anaesthesiology, Lappi Central Hospital, Rovaniemi, Finland.
Acta Anaesthesiol Scand. 1996 Jul;40(6):697-703. doi: 10.1111/j.1399-6576.1996.tb04513.x.
There are few studies in which ketoprofen, a propionic acid derivate NSAID, has been tested as an intravenous postoperative analgesic. The aim of this double-blind, randomized, placebo-controlled work was to study the tolerability and efficacy of intravenous ketoprofen in seventy-six patients undergoing hip or knee total endoprothesis surgery using three different doses.
The patients received either ketoprofen 50 mg, 100 mg or 150 mg, or placebo as an initial intravenous loading, followed by an infusion containing 50 mg, 100 mg or 150 mg or placebo, respectively, over the following eleven and a half hours. The consumption of fentanyl was recorded and the patients assessed their pain intensity on a 10-cm visual analogue scale (VAS) at 0, 2, 4 and 12 hours. Possible side-effects were recorded at the same intervals.
Patients receiving ketoprofen showed significantly lower total fentanyl consumption and significantly better pain relief at 12 hours was achieved by a 300 mg dose of ketoprofen than by placebo. Side-effects were minimal, with no differences between the groups.
A bolus of ketoprofen following continuous infusion of ketoprofen, coupled with a PCA-system, was an effective and safe approach for the relief of postoperative pain.
丙酸衍生物非甾体抗炎药酮洛芬作为静脉术后镇痛药进行测试的研究较少。这项双盲、随机、安慰剂对照研究的目的是使用三种不同剂量研究静脉注射酮洛芬在76例接受髋关节或膝关节全关节置换手术患者中的耐受性和疗效。
患者接受50毫克、100毫克或150毫克酮洛芬或安慰剂作为初始静脉负荷剂量,随后在接下来的十一个半小时内分别接受含50毫克、100毫克或150毫克或安慰剂的输注。记录芬太尼的消耗量,患者在0、2、4和12小时时通过10厘米视觉模拟量表(VAS)评估疼痛强度。在相同时间间隔记录可能的副作用。
接受酮洛芬治疗的患者芬太尼总消耗量显著降低,300毫克剂量的酮洛芬在12小时时的疼痛缓解效果明显优于安慰剂。副作用最小,各治疗组之间无差异。
连续输注酮洛芬后推注酮洛芬,结合患者自控镇痛系统,是缓解术后疼痛的一种有效且安全的方法。