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

Abstract

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.

Intravenous analgesics for pain management in postoperative patients: a comparative study of their efficacy and adverse effects

“…The study was performed according to the guidelines of the Declaration of Helsinki [4] and was registered with the Chinese Clinical Trials Registry (CCTR no. 003241).…”

“…The use of a combination of analgesics from different pharmacological drug classes to manage post-operative pain should improve the safety and efficacy of pain therapy due to their different mechanisms of action and by limiting the severity of adverse events of the individual drugs, since opioids alone sometimes provide insufficient post-operative analgesia. Understandably, a demand exists for the clinical investigation of drugs with special reference to adverse events, for analgesic use as part of combination therapy during the post-operative period [4].…”

Combination of nefopam and remifentanil is more effective to reduce rocuronium-induced withdrawal response compared with remifentanil alone: a prospective, double-blinded, randomized control study

“…Even though tachycardia and profuse sweating occurred more frequently, many studies reported that these adverse events associated with nefopam were not observed or were minor. In addition, nefopam was recently reported to cause frequent injection pain [24]. Kim et al [24] showed that the incidence of injection pain was lower in patients infused with 30 mg nefopam at 60 ml/h (over 20 minutes), compared with that at a rate greater than 120 ml/h (below 10 minutes).…”

“…In addition, nefopam was recently reported to cause frequent injection pain [24]. Kim et al [24] showed that the incidence of injection pain was lower in patients infused with 30 mg nefopam at 60 ml/h (over 20 minutes), compared with that at a rate greater than 120 ml/h (below 10 minutes). Kim and Abdi [11] also suggested that intravenous nefopam should be slowly infused in single doses of 20 mg over 15 to 20 minutes to minimize adverse effects during treatment of neuropathic pain.…”

Efficacy of Nefopam Analgesia for Trauma Patients in the Emergency Department

“…(17) The analgesic mechanism of nefopam is unique, and, to date, fewer adverse effects, such as sedation (25%), sweating (23.9%), tachycardia (12%), and nausea (10.9%), have been reported. (18) Nefopam may be a reasonable alternative for analgesia in trauma patients in acute care settings such as the ED.…”