Prolonged withdrawal delirium in concomitant diphenhydramine and nefopam dependence: A case report

Lin, Ko-Huan; Chen, Yu-Jung; Wei, Chen-Fung; Yen, Ming-Hang; Hsueh, Wen-Chie; Liao, Kun-Chu; Lu, Chao-Lin

doi:10.1016/j.pnpbp.2010.02.026

Cited by 9 publications

(3 citation statements)

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“…Case reports of elderly individuals have suggested that nefopam may be associated with neurologic adverse effects such as delirium, confusion, and convulsion (25,26). The incidence of neurologic adverse effects of nefopam was not observed in the present study because we excluded patients with impaired cognitive function.…”

Section: Discussionmentioning

confidence: 70%

Effects of nefopam with fentanyl in intravenous patient-controlled analgesia after arthroscopic orthopedic surgery: a prospective double-blind randomized trial

Oh¹,

Kim²,

Jeong³

et al. 2018

Turk J Med Sci

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Background/aim: We performed this prospective randomized double-blind study to compare the effects of nefopam versus ketorolac in intravenous fentanyl-based patient-controlled analgesia (PCA) after shoulder arthroscopic orthopedic surgery.Materials and methods: Ninety-two patients were randomly divided into two groups to receive intravenous PCA. Patients were assigned to either the nefopam group (nefopam 120 mg and fentanyl 20 µg/kg) or the ketorolac group (ketorolac 2 mg/kg and fentanyl 20 µg/kg). Pain was assessed on a visual analogue scale (VAS) and a numeric rating scale (NRS). Additionally, patient satisfaction, adverse events, and vital signs were monitored.Results: There were no significant differences in VAS score (P = 0.48) or NRS score (P = 0.15) between the two groups. Similarly, patient satisfaction did not differ between the two groups [8.5(0.8) vs. 8.2(1.0), P = 0.14]. There were no statistically significant differences in the incidence of nausea (P = 0.72), vomiting (P = 0.46), urinary retention (P = 0.82), sweating (P = 0.49), or dizziness (P = 0.45) between the two groups. Likewise, there were no differences in heart rate [78.2(7.7) vs. 75.2(6.5), P = 0.18] or SpO2 [98.4(1.8) vs. 98.5(1.9), P = 0.83]. Conclusion:Nefopam is an appropriate alternative for co-administration with fentanyl-based PCA in patients who have difficulty using nonsteroidal antiinflammatory drugs.

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Section: Discussionmentioning

confidence: 70%

Effects of nefopam with fentanyl in intravenous patient-controlled analgesia after arthroscopic orthopedic surgery: a prospective double-blind randomized trial

Oh¹,

Kim²,

Jeong³

et al. 2018

Turk J Med Sci

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“…Nefopam is a centrally acting benzoxazocine analgesic, and is a cyclized analogue of diphenhydramine. Nefopam could be related neurologic side effects such as delirium, confusion and seizure in old age 22 , 23 . But this study excluded patients who have psychological disorder, old age, or preoperative administration of drugs that have an effect on patient's neurology.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Clinical Trial of Nefopam versus Ketorolac Combined With Oxycodone in Patient-Controlled Analgesia after Gynecologic Surgery

Hwang¹,

Kwon²,

Lee³

et al. 2015

Int. J. Med. Sci.

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Objectives: Nefopam is a centrally-acting non-opioid analgesic, which has no effect on bleeding time and platelet aggregation. There has been no study about nefopam and oxycodone combination for postoperative analgesia. In this study, we present efficacy and side effects of nefopam/oxycodone compared with ketorolac/oxycodone in patient-controlled analgesia (PCA) after gynecologic surgery.Methods: 120 patients undergoing gynecologic surgery were divided randomly into two groups: Nefopam group treated with oxycodone 1 mg and nefopam 1 mg bolus; and Ketorolac group treated with oxycodone 1 mg and ketorolac 1.5 mg bolus. After the operation, a blinded observer assessed the pain with a numeric rating scale (NRS), infused PCA dose and sedation score at 1, 4, 24, and 48 h, nausea, vomiting, headache, shivering, pruritus and delirium at 6, 24 and 48 h, and satisfaction at 48 h after the operation.Results: Nefopam group showed less nausea than Ketorolac group within 6 h after the operation. There were no significant differences in demographic data and other complications between both groups. At 48 h after operation, satisfaction and the infused PCA volumes of Nefopam group (34.0± 19.7 ml) showed no significant differences compared to Ketorolac group (30.7± 18.4 ml, P-value= 0.46).Conclusion: Nefopam showed a similar efficacy and lower incidence of nausea within 6 h after the operation to that of ketorolac in PCA. Nefopam may be a useful analgesic drug for the opioid-based PCA after gynecologic surgery. Further evaluation of accurate equivalent dose of nefopam as well as pharmacokinetics of bolus administration is required.

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“…B. [5 -7] [20]. Die für gewöhnlich empfohlene Dosis beträgt zur kurzfristigen Behandlung von Ein-und Durchschlafstörungen 50 mg zur Nacht.…”

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Diphenhydramin-Abhängigkeit und -Entzug

Erbe

Bschor

2013

Psychiat Prax

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Prolonged withdrawal delirium in concomitant diphenhydramine and nefopam dependence: A case report

Cited by 9 publications

References 4 publications

Effects of nefopam with fentanyl in intravenous patient-controlled analgesia after arthroscopic orthopedic surgery: a prospective double-blind randomized trial

Effects of nefopam with fentanyl in intravenous patient-controlled analgesia after arthroscopic orthopedic surgery: a prospective double-blind randomized trial

A Randomized Clinical Trial of Nefopam versus Ketorolac Combined With Oxycodone in Patient-Controlled Analgesia after Gynecologic Surgery

Diphenhydramin-Abhängigkeit und -Entzug

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