The effect of the addition of nefopam to intraoperative ketoprofen and acetaminophen on postoperative morphine requirements after laparoscopic cholecystectomy: a randomized controlled trial

ZEENI, Carine A.; KADDOUM, Roland N.; AOUAD, Marie T.; SHEBBO, Fadia M.; RAMADAN, Jowana G.; HABLI, Yasmine A.; HASSANI, Jana R.; SIDDIK-SAYYID, Sahar M.

doi:10.23736/s0375-9393.23.17542-0

Cited by 1 publication

(1 citation statement)

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“…Recent findings suggest that combining nefopam with other non-opioid analgesics could result in lower pain intensity. A study demonstrated that the combination of nefopam with ketoprofen and acetaminophen significantly improved postoperative pain management and reduced opioid consumption [ 31 ]. Patients receiving this multimodal analgesic regimen exhibited lower morphine requirements and better pain control compared to those given fewer or no non-opioid analgesics.…”

Section: Discussionmentioning

confidence: 99%

Impact of Intraoperative Nefopam on Postoperative Pain, Opioid Use, and Recovery Quality with Parietal Pain Block in Single-Port Robotic Cholecystectomy: A Prospective Randomized Controlled Trial

Lee,

Kim,

Park

et al. 2024

Medicina

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Background and Objectives: This study explored how nefopam, a non-opioid analgesic in a multimodal regimen, impacts postoperative pain, opioid use, and recovery quality in single-port robot-assisted laparoscopic cholecystectomy (RALC) patients with a parietal pain block, addressing challenges in postoperative pain management. Materials and Methods: Forty patients scheduled for elective single-port RALC were enrolled and randomized to receive either nefopam or normal saline intravenously. Parietal pain relief was provided through a rectus sheath block (RSB). Postoperative pain was assessed using a numeric rating scale (NRS) in the right upper quadrant (RUQ) of the abdomen, at the umbilicus, and at the shoulder. Opioid consumption and recovery quality, measured using the QoR-15K questionnaire, were also recorded. Results: The 40 patients had a mean age of 48.3 years and an average body mass index (BMI) of 26.2 kg/m2. There were no significant differences in the pre- or intraoperative variables between groups. Patients receiving nefopam reported significantly lower RUQ pain scores compared to the controls, while the umbilicus and shoulder pain scores were similar. Rescue fentanyl requirements were lower in the nefopam group in both the PACU and ward. The QoR-15K questionnaire scores for nausea and vomiting were better in the nefopam group, but the overall recovery quality scores were comparable between the groups. Conclusions: Nefopam reduces RUQ pain and opioid use post-single-port RALC with a parietal pain block without markedly boosting RSB’s effect on umbilicus or shoulder pain. It may also better manage postoperative nausea and vomiting, underscoring its role in analgesia strategies for this surgery.

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Section: Discussionmentioning

confidence: 99%