Nefopam as an adjunct to intravenous patient‐controlled analgesia after renal transplantation: a randomised trial

Kim, So Yeun; Huh, Kyu Ha; Roh, Yun Ho; Oh, Yeon Joung; Park, J.; Choi, Yong Seon

doi:10.1111/aas.12519

Cited by 12 publications

(14 citation statements)

References 27 publications

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“…In Choi et al with maxillofacial surgery, nefopam did not reduce PONV incidence compared with fentanyl, despite of similar analgesic effect [25]. However, several studies showed that nefopam was effective for moderate to high postoperative pain control [26][27][28][29]. In our result, as is consistent with previous results, using nefopam in IV-PCA showed similar effectiveness to conventional fentanyl-based regimen.…”

Section: Discussionsupporting

confidence: 89%

The effect of using nefopam in fentanyl-based intravenous patient-controlled analgesia on the incidence of postoperative nausea and vomiting in laparoscopic gynecological surgery

Chung

et al. 2021

Med Biol Sci Eng

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Currently, the regimen of intravenous patient-controlled analgesia (IV-PCA) has become lowering opioid to reduce opioid-related side effects, particularly, postoperative nausea and vomiting (PONV). Using nefopam in IV-PCA may decrease the incidence of PONV, but there is still a lack of evidence. 178 patients undergoing laparoscopic gynecological surgery were randomly assigned into two groups. The IV-PCA regimen for group F was 20 mg/kg fentanyl and for group N was 10 mg/kg fentanyl with 200 mg of nefopam. The severity of PONV and pain were assessed at both 1 hour and 24 hours after surgery. Patients' satisfaction with recovery was evaluated by a structured questionnaire. The incidence of PONV showed no statistical difference between group N and group F (28.2% vs. 26.8% at 1 hour, p=0.839 and 32.1% vs. 43.9% at 24 hours, p=0.120, respectively). Also, postoperative pain intensity showed no statistical difference between the two groups. Patient recovery was similar between the two groups. The combined use of nefopam in IV-PCA seems to effectively decrease the fentanyl dose in laparoscopic gynecological surgery. However, it did not contribute to decreasing the incidence of PONV.

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Section: Discussionsupporting

confidence: 89%

The effect of using nefopam in fentanyl-based intravenous patient-controlled analgesia on the incidence of postoperative nausea and vomiting in laparoscopic gynecological surgery

Chung

et al. 2021

Med Biol Sci Eng

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“…Nefopam is a common postoperative non-opioid, non-steroidal analgesia. The main mechanism of analgesic action of nefopam is through the inhibition of serotonin, norepinephrine and dopamine reuptake [51,52,53,54,55]. A clinical study conducted by Kim and colleagues have demonstrated that patients who were administrated nefopam 48 hours post renal transplant operation consumed 19% less fentanyl compared to the control group.…”

Section: Pain Medication Opioid Analgesics and Non-steroidal Antimentioning

confidence: 99%

“…A clinical study conducted by Kim and colleagues have demonstrated that patients who were administrated nefopam 48 hours post renal transplant operation consumed 19% less fentanyl compared to the control group. This study suggests that nefopam as an adjunct to standard analgesia, fentanyl, reduced postoperative fentanyl consumption besides also providing better analgesia [54]. In a novel review by Girard et al [55], they have compiled the studies where nefopam was used in combinations with opioids, paracetamol and non-steroidal anti-inflammatory drugs in both preclinical and clinical setting.…”

Section: Pain Medication Opioid Analgesics and Non-steroidal Antimentioning

confidence: 99%

Molecular Basis of Cancer Pain Management: An Updated Review

2019

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Pain can have a significantly negative impact on the quality of life of patients. Therefore, patients may resort to analgesics to relieve the pain. The struggle to manage pain in cancer patients effectively and safely has long been an issue in medicine. Analgesics are the mainstay treatment for pain management as they act through various methods on the peripheral and central pain pathways. However, the variability in the patient genotypes may influence a drug response and adverse drug effects that follow through. This review summarizes the observed effects of analgesics on UDP-glucuronosyl (UGT) 2B7 isoenzyme, cytochrome P450 (CYP) 2D6, μ-opioid receptor μ 1 (OPRM1), efflux transporter P-glycoprotein (P-gp) and ATP-binding cassette B1 ABCB1/multiple drug resistance 1 (MDR1) polymorphisms on the mechanism of action of these drugs in managing pain in cancer. Furthermore, this review article also discusses the responses and adverse effects caused by analgesic drugs in cancer pain management, due to the inter-individual variability in their genomes.

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“…However, other studies have reported that using nefopam in conjunction with opioids for PCA has opioid sparing effects, which can result in a lower incidence of PONV than when using opioids alone [1639404142]. We may not have observed any benefits of nefopam on incidence of PONV because our study population consisted of patients who underwent orthognathic surgery.…”

Section: Discussionmentioning

confidence: 95%

Effects on postoperative nausea and vomiting of nefopam versus fentanyl following bimaxillary orthognathic surgery: a prospective double-blind randomized controlled trial

Choi

Karm

et al. 2019

J Dent Anesth Pain Med

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Background Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. Methods Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl 700 µg was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. Results Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were 4.4 ± 2.0 and 3.7 ± 1.9 in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was 10.7 ± 13.7 and 8.6 ± 8.5, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. Conclusion Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.

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Nefopam as an adjunct to intravenous patient‐controlled analgesia after renal transplantation: a randomised trial

Abstract: In combination with fentanyl PCA, nefopam reduced post-operative fentanyl consumption with superior analgesia after renal transplantation.

Cited by 12 publications

References 27 publications

The effect of using nefopam in fentanyl-based intravenous patient-controlled analgesia on the incidence of postoperative nausea and vomiting in laparoscopic gynecological surgery

The effect of using nefopam in fentanyl-based intravenous patient-controlled analgesia on the incidence of postoperative nausea and vomiting in laparoscopic gynecological surgery

Molecular Basis of Cancer Pain Management: An Updated Review

Effects on postoperative nausea and vomiting of nefopam versus fentanyl following bimaxillary orthognathic surgery: a prospective double-blind randomized controlled trial

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