Assessment of the analgesic efficacy of nefopam hydrochloride after upper abdominal surgery: A study using patient controlled analgesia

McLintock, T.; Kenny, G. N. C.; Howie, J. C.; McArdle, C. S.; Lawrie, Sophie; Aitken, H.A.

doi:10.1002/bjs.1800750818

Cited by 62 publications

(47 citation statements)

References 15 publications

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“…every 6 h for 24 h (cumulative dose, 100 mg) in patients undergoing upper abdominal surgery, 18 or 20 mg i.v. every 4 h for 24 h (cumulative dose, 120 mg) in patients undergoing hepatic resection, 20 or hip arthroplasty.…”

Section: Pain Outcomesmentioning

confidence: 99%

Nefopam for the prevention of postoperative pain: quantitative systematic review

Evans

Lysakowski

Tramèr

2008

British Journal of Anaesthesia

125

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Nefopam, a centrally acting analgesic, has been used in the surgical setting in many countries since the mid-1970s. However, clinical trials provide contflicting results for its analgesic potency. We performed a systematic search (multiple databases, bibliographies, any language, to January 2008) for randomized, placebo-controlled trials of nefopam for the prevention of postoperative pain. Data were combined using classic methods of meta-analyses and were expressed as weighted mean difference (WMD), relative risk (RR), and number needed to treat/harm (NNT/H) with 95% confidence interval (CI). Nine trials (847 adult patients, 359 received nefopam) were included. Nefopam (cumulative doses, 20 -160 mg) was given orally or i.v., as single or multiple doses, or as a continuous infusion. Compared with placebo, cumulative 24 h morphine consumption was decreased with nefopam: WMD 213 mg (95% CI 217.9 to 28.15). Pain intensity at 24 h was also decreased: on a 100 mm visual analogue scale, WMD 211.5 mm (95% CI 215.1 to 27.85). The incidence of tachycardia was increased with nefopam (RR 3.12, 95% CI 1.11 -8.79; NNH 7), as was the incidence of sweating (RR 4.92, 95% CI 2.0 -12.1; NNH 13). There is limited evidence from the published literature that nefopam may be a useful non-opioid analgesic in surgical patients. The analgesic potency seems to be similar to non-steroidal anti-inflammatory drugs. However, dose responsiveness and adverse effect profile remain unclear, and the role of nefopam as part of multimodal analgesia needs to be established. Data in children are lacking.

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Section: Pain Outcomesmentioning

confidence: 99%

Nefopam for the prevention of postoperative pain: quantitative systematic review

Evans

Lysakowski

Tramèr

2008

British Journal of Anaesthesia

125

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“…5 Studies have consistently demonstrated a 30-40% decrease in postoperative opioid consumption when nefopam is used following abdominal or orthopaedic surgery. 6,7 Unlike nonsteroidal anti-inflammatory drugs, nefopam has no effect on platelet function, 8 and (in contrast to opioids) does not increase the risk of respiratory depression. 9 In addition, nefopam has been shown to result in decreased morphine consumption when used as a coanalgesic following abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

The analgesic efficacy and safety of nefopam in patient-controlled analgesia after cardiac surgery: A randomized, double-blind, prospective study

Kim

Choi

et al. 2014

J Int Med Res

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Objective: The efficacy and side-effects of nefopam were prospectively compared with those of fentanyl for patient-controlled analgesia (PCA) following cardiac surgery. Methods: Patients scheduled to undergo cardiac surgery were randomly assigned between three PCA groups (nefopam, fentanyl or nefopam þ fentanyl). Pain was assessed at rest and during movement at 12, 24, 36, 48 and 72 h after surgery using a visual analogue scale (VAS). Total infused PCA volume, number of rescue drug injections, duration of intubation and length of stay in the intensive care unit were recorded. The incidence of adverse effects was noted at 48 h postoperatively. Results: There were no significant between-group differences in VAS score, total PCA infusion volume or number of rescue injections (n ¼ 92 per group). Nausea was significantly more common in the fentanyl group compared with both other groups. Conclusions: PCA with nefopam alone provides suitable postoperative analgesia after cardiac surgery.

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“…The nefopam-induced strong inhibition of nociceptive reflexes in volunteers confirmed its central action site 9. Several studies demonstrated its efficacy during the postoperative period 4 16 17. The usual IV dose of nefopam is 20 mg, which has an analgesic potency equivalent to 6–12 mg of morphine 18 19.…”

Section: Introductionmentioning

confidence: 87%

Usefulness of nefopam in treating pain of severe uncomplicated renal colics in adults admitted to emergency units: a randomised double-blind controlled trial. The ‘INCoNU’ study

et al. 2012

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Assessment of the analgesic efficacy of nefopam hydrochloride after upper abdominal surgery: A study using patient controlled analgesia

Cited by 62 publications

References 15 publications

Nefopam for the prevention of postoperative pain: quantitative systematic review

Nefopam for the prevention of postoperative pain: quantitative systematic review

The analgesic efficacy and safety of nefopam in patient-controlled analgesia after cardiac surgery: A randomized, double-blind, prospective study

Usefulness of nefopam in treating pain of severe uncomplicated renal colics in adults admitted to emergency units: a randomised double-blind controlled trial. The ‘INCoNU’ study

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