Analgesia after Administration of One or Two Dose of Nefopam for Appendectomy: a Randomized Controlled Trial

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Phakaporn Chompubai


Background: Nefopam can be used as adjuvant for
postoperative pain control and recommended dose is
80 mg per day.
Objectives: To compare the analgesic effects 20 and
40 mg of nefopam after appendectomy.
Methods: A prospective randomized double-blind,
placebo-controlled study in 3 groups of patients. Group S
received one dose of 20 mg of nefopam, group D received
two doses of 20 mg of nefopam, and group C received
placebo. The primary outcome was 24-hour morphine
consumption from patient controlled analgesia (PCA).
Secondary outcomes were pain score, time to first rescue
analgesia, time to first ambulation, and side effects.
Results: Each group consisted of 30 patients. The 24-hour
morphine consumption in groups S, D and C was 21.07,
22.93 and 27.90 mg, respectively (p=0.213). Morphine
consumption reduced in Groups S and D 18 hours
post-operation compared with group C. The pain scores,
times to first rescue analgesia, and satisfaction were
similar. First time to ambulation(walking) in Groups S, D
and C were 11.63 ± 5.16, 13.53 ± 5.68 and 17.57 ± 6.39
hours after surgery, respectively (p=0.0005). Tachycardia
was the side effect found only in groups S and D at 20%
and 3.33%, respectively (p=0.015).
Conclusions: Nefopam 20 and 40 mg after appendectomy
reduced morphine consumption with no statistical significance, but patient showed early ambulation. The
most common side effect was tachycardia.

Article Details

Original articles


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