The Effect of Nefopam Administration during Laparoscopic Cholecystectomy in Postoperative Pain Management
Nefopam Administration during Laparoscopic Cholecystectomy
Keywords:
laparoscopic cholecystectomy, postoperative pain management, nefopamAbstract
Multimodal analgesia decreases opioid consumption and associated adverse effects. Continuous use of nefopam reduces postoperative pain and opioid requirement. The purpose of prospective randomized double-blind, placebo-controlled study was to compare its effectiveness in analgesia of postoperative morphine after one dose of 20-mg intravenous nefopam versus placebo during laparoscopic cholecystectomy. Forty five laparoscopic cholecystectomy patients were enrolled and 42 of them were analyzed (21 patients in each group). Mean age were 48 years (21-63 years) and 73.8% were female (n = 31). The amount of morphine received in the post-anesthesia care unit (PACU) were 4.90 mg in nefopam group and 4.86 mg in placebo group, respectively (p = 0.952). The amount of morphine received 24 hours after surgery in nefopam and placebo groups were 6.14 and 5.81 mg, respectively (p = 0.743). Adverse effects i.e., nausea, vomiting, tachycardia, sweating and pruritus in both groups were not different. Forty three percent in both groups experienced nausea and vomiting. One patient in each group had postoperative urinary retention. In conclusion, single dose of nefopam during laparoscopic cholecystectomy does not affect the amount of morphine use in PACU and 24-hour post operation compared to placebo. However, adverse events are not different between two groups
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