奈福泮用于接受悬雍垂腭咽成形术的阻塞性睡眠呼吸暂停患者术后疼痛管理的随机试验。
A randomized trial of nefopam for postoperative pain management in obstructive sleep apnea patients undergoing uvulopalatopharyngoplasty.
文献信息
| PMID | 42747527 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Saowapark Chumpathong |
| 作者单位 | Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 悬雍垂腭咽成形术（UPPP）是阻塞性睡眠呼吸暂停的一种手术治疗方法，常导致显著的术后疼痛。鉴于阻塞性睡眠呼吸暂停患者使用阿片类药物存在风险，多模式镇痛更受青睐。本研究评估了奈福泮——一种无呼吸抑制作用的非阿片类镇痛药——是否能减少接受UPPP患者的吗啡消耗量并改善术后恢复。
方法： 这项前瞻性、探索性、随机、三盲试验纳入了计划接受择期UPPP的患者。参与者被随机分配接受奈福泮或安慰剂（生理盐水）。奈福泮组接受20 mg静脉负荷剂量，输注1小时，随后24小时内持续输注80 mg。两组均接受标准多模式镇痛。主要结局为术后24小时内的总吗啡消耗量。次要结局为术后疼痛评分、首次经口进食时间、患者满意度、生活质量评分及不良事件。
结果： 共分析51例患者（奈福泮组：26例，对照组：25例）。奈福泮组24小时吗啡消耗量中位数为7 mg，对照组为5 mg（P = 0.56）。两组在术后疼痛评分、首次经口进食时间、患者满意度或生活质量评分方面均未发现显著差异。不良事件发生率相似，尽管心动过速（11.5%）和出汗（3.8%）仅见于奈福泮组。在单纯UPPP和扩大UPPP手术的亚组分析中， likewise未显示两组间存在显著差异。
结论： 不推荐将奈福泮用于UPPP术后的疼痛管理，因为它并未显著减少吗啡消耗量或改善疼痛相关结局。
英文摘要
OBJECTIVE: Uvulopalatopharyngoplasty (UPPP) is a surgical treatment for obstructive sleep apnea that often results in significant postoperative pain. Given the risks associated with opioid use in patients with obstructive sleep apnea, multimodal analgesia is preferred. This study evaluated whether nefopam, a non-opioid analgesic, without respiratory depressive effects, could reduce morphine consumption and improve postoperative recovery in patients undergoing UPPP.
METHODS: This prospective, exploratory, randomized, triple-blinded trial enrolled patients scheduled for elective UPPP. Participants were randomly assigned to receive either nefopam or a placebo (normal saline). The nefopam group received a 20 mg intravenous loading dose over 1 h, followed by a continuous infusion of 80 mg over 24 h. Both groups received standard multimodal analgesia. The primary outcome was total morphine consumption within 24 h postoperatively. The secondary outcomes were postoperative pain scores, time to first oral intake, patient satisfaction, quality-of-life scores, and adverse events.
RESULTS: Fifty-one patients were analyzed (nefopam: 26, control: 25). The median 24-hour morphine consumption was 7 mg in the nefopam group and 5 mg in the control group (P = 0.56). No significant differences were found between groups in postoperative pain scores, time to first oral intake, patient satisfaction, or quality-of-life scores. Adverse event rates were similar, although tachycardia (11.5%) and sweating (3.8%) were observed only in the nefopam group. Subgroup analysis in UPPP alone and extended UPPP surgery likewise revealed no significant differences between groups.
CONCLUSION: Nefopam is not recommended for pain management following UPPP as it did not significantly reduce morphine consumption or improve pain-related outcomes.