盐酸奈福泮超前镇痛在乳腺区段切除术的临床研究  

An intravenous bolus injection of 20 mg nefopam as a preemptive analgesia in mastectomy

作　　者：夏氢[1] 李卫[1] 李秀泽[1] 畅文丽[1] 杨天凤[1] 唐晓凤[1] 赖庆莉[1] 

机构地区：[1]绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《四川医学》2009年第2期185-186,共2页Sichuan Medical Journal

摘　　要：目的研究盐酸奈福泮超前镇痛在乳腺区段切除术的镇痛效果及不良反应。方法60例择期局麻下乳腺肿块区段切除术患者,随机分为奈福泮超前镇痛组(N组)及安慰剂对照组(C组),每组患者30例。观察术中疼痛评分(VAS)、镇静评分(White)、局麻药用量及恶心呕吐、头昏、皮肤瘙痒、尿潴留等不良反应。结果奈福泮组疼痛评分明显低于对照组(P<0.05),实验组局麻药用量明显少于对照组(P<0.01),恶心、呕吐等不良反应发生率在两组比较差异有统计学意义。结论盐酸奈福泮超前镇痛用于乳腺区段切除术可以减轻患者的疼痛不适,减少局麻药用量,而且不良反应小,值得临床推广使用。Objective To evaluate the analgesia and the safety of preemptive nefopam used the double blind,randomize and placebo control method. Methods Sixty female patients with ASA Ⅰ-Ⅱ scheduled for Segmental mastectomy under local anaesthesia were randomly divided into two groups with 30 patients each. In group N, an intravenous bolus injection of 20 mg nefopam（ 1 ml）was given before the start of operation. In group C, 1 ml of N. S was given. The maintenance of anesthesia were given local infiltration anaesthesia during the procedure, the local anaesthetic agents was 1% lidocaine. Chenges in MAP, HR, RR, SpO2 during operation were observed, the total dosage of local anaesthetic agents was recorded, the estimation of visual analogue scale of pain（VAS）, the sedation score and the adverse effects were assessed. Results The two groups were comparable with respect to demographic data, duration of surgery. There were no difference of MAP,HR,RR,SpO2 between the two groups.The VAS scores was lower in group N than that in group C（ P 〈 0.05） .The total dosage of local anaesthetic agents was less in group N than that in group C（ P 〈 0.01 ）. No significant difference was observed in sedation scores ,the incidences of the adverse effects such as nausea, vomiting and dizziness between the two groups. Conclusion Dosage of 20mg nefopam 30min intravenously before operation as a preemptive analgesia for Segmental mastectomy can significantly allevate the pain of the patients and with less anesthetic consumption and no seriously side effects.

关 键 词：超前镇痛 乳腺区段切除 奈福泮 

分 类 号：R614[医药卫生—麻醉学]