So sánh hiệu quả giảm đau bằng phương pháp sử dụng nefopam và ketorolac đường tĩnh mạch do bệnh nhân tự điều khiển ở bệnh nhân sau phẫu thuật lấy thai tại Bệnh viện Phụ sản Hà Nội năm 2024–2025

Postoperative pain management remains a critical aspect of patient care, particularly following a cesarean section, a common surgical procedure globally and with a high incidence in Vietnam. Inadequate control of postoperative pain can significantly impede recovery, compromise maternal well-being, and lead to chronic pain. While patient-controlled intravenous analgesia (PCA) using opioids has been a standard approach, it carries notable risks, including respiratory depression and other adverse effects. This necessitates the exploration of safer and equally effective analgesic alternatives. This study aims to address this clinical need by comparing the analgesic efficacy of intravenous Nefopam and Ketorolac, administered via PCA, in patients undergoing cesarean section, seeking to identify optimal pain management strategies that mitigate opioid-related complications.

Medical professionals, including anesthesiologists, obstetricians, general surgeons, pain management specialists, and researchers interested in optimizing postoperative pain protocols, especially for cesarean section patients.

This controlled clinical intervention sought to compare the analgesic efficacy of intravenous patient-controlled Nefopam and Ketorolac in managing postoperative pain after cesarean section. Conducted on 60 parturients at Hanoi Obstetrics and Gynecology Hospital, participants were divided into two groups, each receiving either Nefopam or Ketorolac via patient-controlled intravenous analgesia (PCA) on a background of regular Paracetamol. The primary outcomes assessed were pain intensity using VAS scores, total PCA drug consumption, and patient satisfaction over 48 hours post-surgery. The study revealed that both Nefopam and Ketorolac provided equivalent analgesic efficacy across all evaluated time points, maintaining mild pain levels (VAS ≤ 2) for the first 24 hours. There was no statistically significant difference in the total PCA dose consumed between the two groups after 48 hours. Crucially, high patient satisfaction was observed in both groups (Nefopam 76.7%, Ketorolac 80.0%), and no patients required Morphine rescue, underscoring the opioid-sparing potential of these drugs. These findings suggest that Nefopam and Ketorolac, when used alone as part of patient-controlled intravenous analgesia, are effective and safe alternatives for postoperative pain management after cesarean section. This approach can help minimize opioid-related side effects while ensuring adequate pain relief and high patient satisfaction, thereby improving recovery outcomes and providing clinicians with valuable data for individualizing pain protocols.