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KMID : 0363120160290020110
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Korean Journal of Pain
2016 Volume.29 No. 2 p.110 ~ p.118
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The Effect of Nefopam on Postoperative Fentanyl Consumption: A Randomized, Double-blind Study
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Moon Jee-Youn
Choi Sang-Sik
Lee Shin-Young
Lee Mi-Kyung
Kim Jung-Eun
Lee Ji-Eun
Lee So-Hyun
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Abstract
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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.
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KEYWORD
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Deep sedation, Double blind study, Hysterectomy, Nefopam, Opioids, Pain measurement, Patient-controlled analgesia, Postoperative pain
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