Patient-controlled intravenous analgesia with sufentanyl-nefopam and fentanyl-nefopam after lower limb orthopedic surgery:a comparative study.

Objective To evaluate the efficacy and safety of sulfentanlyl-nefopam and fentanyl-netopam for patient-controlled intravenous analgesia(PCIA)after lower limb surgery with general anesthesia.Methods 60 ASA grade Ⅰ-Ⅱ patients aged 20-60 undergoing lower limb surgery with general aneathesia were randomly divided into two groups:sufentanil-nefopam(S,n=30)versus fentanil-nefopam(F,n=30).The patients in group S received 1μg/ml sufentanil、1mg/ml nefopam plus 30 μg/ml granisetron,with a total volume of 100 ml,in group F 10μg/ml fentanyl、1mg/ml nefopam plus 30μg/ml granisetron.PCIA parameters were a bolus dose of 1.0ml,lockout time of 15 minutes and continuous infusion of 1.5ml/h.Vital signs including MAP、HR、RR、SpO2,the pain intensity ac-cording to visual analogue scale(VAS)at rest and during mobilization,satisfaction、sedation scores and side effects such as nausea、vomiting、urine retention、pruritus、breath depression were recorded at 4,12,24 and 48h postoperatively;the total number of PCA and other analgesics were be recorded.Results The two groups were comparable with respect to demographic data,duration of surgery and duration of anesthesia.There were no difference of MAP、HR、RR、SpO2 between the two groups.The VAS scores at rest and during mobilization was lower in groups S than in group F(P0.01).No significant difference was observed in sedation scores between the two groups.The total number of PCA in group F was more than that in group S(P0.05).The scores of satisfaction of postoperative analgesia was lower in group F than in group S(P0.05).The incidence of nausea or vomiting in group S was lower than that in group F(P0.05).Conclusion PCIA with sufentanyl-nefopam provides better efficacy of analgesia with lower incidence of nausea and vomiting than with fentanyl-nefopam in postoperative patients with lower limb surgery.