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

 S. Y. Kim  ;  K. H. Huh  ;  Y. H. Roh  ;  Y. J. Oh  ;  J. Park  ;  Y. S. Choi 
 Acta Anaesthesiologica Scandinavica, Vol.59(8) : 1068-1075, 2015 
Journal Title
 Acta Anaesthesiologica Scandinavica 
Issue Date
Administration, Intravenous ; Adult ; Analgesia, Patient-Controlled/methods* ; Analgesics, Non-Narcotic/administration & dosage ; Analgesics, Non-Narcotic/therapeutic use* ; Female ; Humans ; Kidney Transplantation* ; Male ; Middle Aged ; Nefopam/administration & dosage ; Nefopam/therapeutic use* ; Pain, Postoperative/drug therapy* ; Treatment Outcome ; Young Adult
BACKGROUND: 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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
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