ISSN: 1859 - 2872
Study on pain relief effect of the intravenous patient-controlled analgesia (PCA), using combined nefopam-fentanyl for postoperative analgesia in patients undergoing spine fixation surgery: A prospective, randomized, controlled, single-blind trial
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Abstract
Objective: To evaluate pain relief efficiently of the intravenous patient-controlled analgesia (PCA), using combined nefopam-fentanyl for postoperative analgesia in patients undergoing spine fixation surgery. Subject and method: 70 patients were randomly assigned to fentanyl 10µg/ml (Group F, n = 35) or fentanyl 10μg/ml with nefopam 1,2mg/ml with (Group NF, n = 35) using intravenous PCA. when postoperative VAS ≥ 4, titration in 48 hours with a background of continous infusion rate of 0.25µg/kg/h; bolus dose amount set at 0.5ml, lockout interval set at 15 minute; maximum dose amount 15ml/4 hours. Result: Both groups were similar for demographic characteristic, surgery, and anesthesia; Pain scores (VAS) at rest were similar at the time of each examination and under 3.5; VAS at exercise was higher in Group FN compared with Group F on the second day of PCA (p<0.05); Cumulative postoperative fentanyl consumptions at postoperative 48 hours was less than 15.2% in Group FN (631.7 ± 51.5µg) compared with Group F (744.6 ± 84.2µg) with p<0.05 on the second day of PCA (p<0.05); The A/D ratio in both groups was > 70%, higher in the higher in group FN compared with Group F at 24 hours with p<0.05. The average number of patients requiring bolus dose in the FN group (11.4 ± 7.6) was less than in the Group F (20.8 ± 11.0) with p<0.05. The percentage of satisfied patients was higher in group FN compared with Group F (77.1% and 62.9%, respectively, with p<0.05). Conclusion: The postoperative intravenous PCA by nefopam combined with fentanyl in spine fixation surgery has good analgesic effect, reducing fentanyl consumption.
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