HIỆU QUẢ CỦA NEFOPAM TIÊM TĨNH MẠCH TRONG MỔ ĐỐI VỚI NHU CẦU FENTANYL VÀ KIỂM SOÁT ĐAU SAU PHẪU THUẬT BỎNG

Abstract

Objective: To evaluate the effect of intraoperative intravenous nefopam on postoperative fentanyl consumption and pain intensity in burn patients, and to assess associated adverse effects.Methods: A prospective randomized controlled trial was conducted on 160 burn patients undergoing escharectomy and skin grafting. The nefopam group (n=80) received 20 mg intravenous nefopam during the last 15 minutes of surgery followed by fentanyl-based patient-controlled analgesia (PCA), while the control group (n=80) received fentanyl PCA alone. Pain intensity (VAS at rest and movement) was assessed at multiple time points within 24 hours postoperatively. Total fentanyl consumption, number of bolus doses, and adverse effects were recorded. Results: Baseline characteristics were comparable between groups. The nefopam group demonstrated a significantly lower total fentanyl consumption (p<0.05) and fewer bolus demands compared to the control group. However, no significant differences in VAS scores at rest or during movement were observed between groups at any time point. The incidence of adverse effects was similar in both groups. Conclusion: Intraoperative intravenous nefopam reduces postoperative fentanyl requirements without significantly affecting pain scores. Nefopam may be a useful component of multimodal analgesia in burn patients.