The Effect of Nefopam on Postoperative Fentanyl Consumption: A Randomized, Double-blind Study.
10.3344/kjp.2016.29.2.110
- Author:
Jee Youn MOON
1
;
Sang Sik CHOI
;
Shin Young LEE
;
Mi Kyung LEE
;
Jung Eun KIM
;
Ji Eun LEE
;
So Hyun LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Deep sedation;
Double blind study;
Hysterectomy;
Nefopam, Opioids;
Pain measurement;
Patient-controlled analgesia;
Postoperative pain
- MeSH:
Analgesia, Patient-Controlled;
Analgesics, Opioid;
Anesthesia, General;
Deep Sedation;
Double-Blind Method*;
Female;
Fentanyl*;
Humans;
Hysterectomy;
Incidence;
Nefopam*;
Pain Measurement;
Pain, Postoperative;
Passive Cutaneous Anaphylaxis
- From:The Korean Journal of Pain
2016;29(2):110-118
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Nefopam is a non-opioid, non-steroidal, centrally acting analgesic drug. The concomitant use of opioids and nefopam is believed to have many advantages over the administration of opioids alone for postoperative pain management. We conducted a randomized, double-blind study to determine the fentanyl-sparing effect of co-administration of nefopam with fentanyl for postoperative pain management via patient controlled analgesia (PCA). METHODS: Ninety female patients who underwent laparoscopic total hysterectomy under general anesthesia were randomized into 3 groups, Group A, fentanyl 1,000 µg; Group B, fentanyl 500 µg + nefopam 200 mg; and Group C, fentanyl 500 µg + nefopam 400 mg, in a total volume of 100 ml PCA to be administered over the first 48 h postoperatively without basal infusion. The primary outcome was total fentanyl consumption during 48 h; secondary outcomes included pain scores and incidence of side effects. RESULTS: Eighty-one patients were included in the analysis. The overall fentanyl-sparing effects of PCA with concomitant administration of nefopam during the first 48 h postoperatively were 54.5% in Group B and 48.9% group C. Fentanyl use was not significantly different between Groups B and C despite the difference in the nefopam dose. There were no differences among the three groups in terms of PCA-related side effects, although the overall sedation score of Group B was significantly lower than that of Group A. CONCLUSIONS: The concomitant administration of nefopam with fentanyl for postoperative pain management may allow reduction of fentanyl dose, thereby reducing the risk of opioid-related adverse effects.
