Effective comparison of intravenous patient controlled analgesia with the Nefopam - Fentanyl mixture and Fentanyl after necrosis excision and skin graft

Abstract

Objectives: Compare the analgesic and adverse effects between intravenous patient-controlled analgesia with Nefopam - Fentanyl mixture and single Fentanyl after burn necrosis excision and skin-graft surgery.
Patients and methods: A prospective study was conducted on 60 patients in the Intensive care unit (ICU) and the Adult Burn Department of Le Huu Trac National Burn Hospital from 11/2019 to 8/202, divided into 2 groups: Group 1 using single Fentanyl; Group 2 using the Nefopam - Fentanyl mixture via intravenous patient-controlled after burn debridement and grafting surgery. Patients were from 16 to 60 years old with an indication surgery, with area ≥ 5% total body area; without contraindications to Nefopam and Fentanyl; without mechanical ventilation or maintaining mechanical ventilation after surgery.
Results: The difference in VAS at rest and movement was not statistically significant. The Fentanyl consumption in group 2 was lower than that in group 1. Although the bolus times were lower, the amount of Fentanyl bolus of patients in group 1 was higher than that in group 2. The “very satisfied” and “satisfied” rates were high in both groups. There were no patients with serious respiratory and circulatory disorders. The rate of nausea and vomiting of patients in group 1 was higher than that in group 2.
Conclusion: Intravenous patient-controlled analgesia with Nefopam - Fentanyl mixture and single Fentanyl had a good analgesic effect after burn necrosis excision and skin graft surgery but the rate of nausea and vomiting of patients in a group using the mixture was lower than that in the other group.