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Intraoperative Nefopam Reduces Acute Postoperative Pain after Laparoscopic Gastrectomy: a Prospective, Randomized Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

We assessed whether intraoperative nefopam would reduce opioid consumption and relieve postoperative pain in patients undergoing laparoscopic gastrectomy.

Methods

The 60 enrolled patients were randomly assigned to the control (n = 32) or nefopam (n = 28) group. All patients were blinded to their group assignment. We administered 100 ml of normal saline only (control group) or 20 mg of nefopam mixed in 100 ml normal saline (nefopam group) after anesthesia induction and at the end of surgery. The cumulative amount of fentanyl via intravenous patient-controlled analgesia (PCA), incidence of rescue analgesic medication, and numerical rating scale (NRS) for postoperative pain were evaluated along with the total remifentanil consumption.

Results

The mean infusion rate of remifentanil was significantly lower in the nefopam group (0.08 ± 0.05 μg/kg/min) than in the control group (0.13 ± 0.06 μg/kg/min) (P < 0.001). Patients in the nefopam group required less fentanyl via intravenous PCA than those in the control group during the first 6 h after surgery (323.8 ± 119.3 μg vs. 421.2 ± 151.6 μg, P = 0.009). Additionally, fewer patients in the nefopam group than in the control group received a rescue analgesic during the initial 6 h postoperatively (78.6 vs. 96.9%, P = 0.028). The NRS measured while patients were in the post-anesthetic care unit was significantly lower in the nefopam group than in the control group (3.8 ± 1.1 vs. 4.8 ± 1.4, P = 0.012). The subsequent NRS obtained after patients had been transferred to the general ward was comparable between the two groups during the following postoperative period.

Conclusions

Intraoperative nefopam decreased postoperative pain and opioid consumption in the acute postoperative period after laparoscopic gastrectomy. Hence, nefopam may be considered as a component of multimodal analgesia after laparoscopic gastrectomy.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea

    Hyo-Seok Na, Ah-Young Oh, Jung-Hee Ryu, Bon-Wook Koo, Sun-Woo Nam, Jihoon Jo & Jae-Hee Park

  2. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    Ah-Young Oh & Jung-Hee Ryu

Authors
  1. Hyo-Seok Na
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  2. Ah-Young Oh
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Contributions

Hyo-Seok Na: conception of the work, writing manuscript. Ah-Young Oh: conception of the work, final approval of manuscript, Jung-Hee Ryu: analysis and interpretation of data, Bon-Wook Koo: acquisition of data, Sun-Woo Nam: acquisition of data, Jihoon Jo: acquisition of data, Jae-Hee Park: acquisition of data.

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Correspondence to Ah-Young Oh.

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Na, HS., Oh, AY., Ryu, JH. et al. Intraoperative Nefopam Reduces Acute Postoperative Pain after Laparoscopic Gastrectomy: a Prospective, Randomized Study. J Gastrointest Surg 22, 771–777 (2018). https://doi.org/10.1007/s11605-018-3681-5

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  • DOI: https://doi.org/10.1007/s11605-018-3681-5

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