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

AbstractBACKGROUND:
Nefopam has been used as an adjuvant to opioid analgesia after operation. We investigated the efficacy of nefopam as an adjunct to fentanyl-based intravenous patient-controlled analgesia (IV PCA) on post-operative pain relief in patients undergoing renal transplantation.
METHODS:
Ninety-eight patients undergoing elective renal transplantation were randomised into two groups: nefopam or control groups. The former received nefopam (160 mg in 200 ml at a rate of 4 ml/h) whereas the latter received normal saline during the first 48 h after reperfusion of grafted kidney. Pain intensity scores, cumulative dose of fentanyl, and the incidence of adverse events were assessed at 1, 6, 12, 24, and 48 h post-operatively. Serum creatinine and estimated glomerular filtration rate were evaluated on post-operative days 1, 2, 4, and 7.
RESULTS:
The cumulative fentanyl consumption during the first 48 h after operation was 19% less in the nefopam group than that in the control group (1005 ± 344 μg vs. 1246 ± 486 μg, mean ± SD; P = 0.006). Pain intensity scores at rest and on coughing were significantly lower in the nefopam group throughout the first 12 and 48 h after operation, respectively. Adverse events and early graft function were comparable between the groups, except a significantly lower incidence of drowsiness observed in the nefopam group (4% vs. 21%, P = 0.027).
CONCLUSION:
In combination with fentanyl PCA, nefopam reduced post-operative fentanyl consumption with superior analgesia after renal transplantation.
AuthorsS Y Kim, K H Huh, Y H Roh, Y J Oh, J Park, Y S Choi
JournalActa anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 59 Issue 8 Pg. 1068-75 (Sep 2015) ISSN: 1399-6576 [Electronic] England
PMID25903742 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Copyright© 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Chemical References
  • Analgesics, Non-Narcotic
  • Nefopam
Topics
  • Administration, Intravenous
  • Adult
  • Analgesia, Patient-Controlled (methods)
  • Analgesics, Non-Narcotic (administration & dosage, therapeutic use)
  • Female
  • Humans
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Nefopam (administration & dosage, therapeutic use)
  • Pain, Postoperative (drug therapy)
  • Treatment Outcome
  • Young Adult

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