Concurrent Use of Nefopam vs. Ketorolac with Opioid Analgesic for Post-operative Pain Management
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Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlledanalgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared toketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted onpatient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgerydepartment from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 generalsurgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control wasnot different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they wereunlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented thatnefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for postoperativepain management in general surgery patients in South Korea.
Abstract
Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlledanalgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared toketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted onpatient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgerydepartment from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 generalsurgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control wasnot different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they wereunlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented thatnefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for postoperativepain management in general surgery patients in South Korea.
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