Abstract

Background: The incidence of moderate to severe pain is high among patients undergoing spinal surgery. Nefopam can be used as an adjuvant analgesic postoperatively after spine surgery. The study aimed to assess the analgesic efficacy and side effects of nefopam on 24-hour postoperative morphine consumption after spine surgery. Methods: The study is a randomized, double-blinded, placebo-controlled trial. A total of 96 patients were randomized into 4 treatment groups, 24 each. In group 1, patients received normal saline before surgical incision and before the end of surgery. In group 2, patients received 30 mg nefopam before surgical incision and normal saline before the end of surgery. In group 3, patients received normal saline before surgical incision and 30 mg of nefopam before the end of surgery. In group 4, patients received 30 mg of nefopam in both timings. Patient-controlled analgesia morphine was used for the postoperative period. Outcomes were to determine 24-hour morphine consumption and incidence of side effects. Results:Of 96 patients enrolled, 21 in placebo-placebo, 22 in nefopam-placebo, 22 in placebo-nefopam and 21 in nefopam-nefopam groups completed the study. Analysis of the Kruskal-Wallis test on the intention-to-treat basis shows no significant difference in 24-hour postoperative morphine consumption between four groups, which were 18 [IQR 13.5-29], 20 [IQR 11-28.3], 17 [IQR 11.5-28.5], 13 [IQR 8.5-18.5] mg., respectively (p = 0.223). Incidence of side effects, including tachycardia, sedation, sweating and nausea/ vomiting, did not differ. Conclusions: Adding perioperative nefopam to opioid analgesic does not improve analgesic efficacy in patients who underwent spine surgery. Registration: Thai Clinical Trials Registry ID TCTR20171115001; registered on 15 November 2017.

Highlights

  • The incidence of moderate to severe pain after spine surgery is 30–64%, especially in the first 3 days after surgery[1,2]

  • The objectives of this study were to determine the analgesic efficacy and side effects of nefopam that administered before surgical incision, or before the end of the surgery, or both timings compared with placebo on postoperative morphine consumption

  • Ethical issues The study was a randomized, double-blinded, placebocontrolled trial. It was approved by the Institutional Review Board of Prasat Neurological Institute (IRBPNI) [Bangkok] and informed consent was obtained from all patients

Read more

Summary

Introduction

The incidence of moderate to severe pain after spine surgery is 30–64%, especially in the first 3 days after surgery[1,2]. NSAIDs work by inhibiting the production of prostaglandins both in the central nervous system and peripheral nervous system through the inhibition of cyclooxygenase (COX) isoenzymes The results of these effects reduce inflammation and pain after surgery. The study aimed to assess the analgesic efficacy and side effects of nefopam on 24-hour postoperative morphine consumption after spine surgery. In group 1, patients received normal saline before surgical incision and before the end of surgery. In group 3, patients received normal saline before surgical incision and 30 mg of nefopam before the end of surgery. Conclusions: Adding perioperative nefopam to opioid analgesic does not improve analgesic efficacy in patients who underwent spine version 2 (revision)

Objectives
Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call