Nefopam is a non-opioid drug that inhibits reuptake of serotonin, norepinephrine, and dopamine. Nafopam is equipotent with opioids (morphine andmeperidine) and can decrease postoperative nausea and vomiting (PONV) by morphine sparing effect. So, we compared postoperative pain and PONV between female patients who received nefopam and fentanyl after laparoscopic cholecystectomy (LC).
Methods: Patients were randomly assigned to two groups: those who received fentanyl 1 μg/kg at skin closure (Group F, n=31) and those who received nefopam 30 mg mixed with normal saline 500 ml for 30 minutes during surgery (Group N, n=31). General anesthesia was induced with lidocaine 40 mg, propofol 2 mg/kg, and rocuronium 0.6 mg/kg and was maintained with desflurane and remifentanil 0.5 -1.5 μg/kg/min. Postoperative pain is assessed using visual analogue scale (VAS). VAS, rescue analgesics (fentanyl and ketorolac doses), and PONV were evaluated for 0-2 hr, 2-6 hr, 6-12 hr, and 12-24 hr after surgery.
Results: Age-adjusted VAS significantly decreased during the four assessment time periods in both groups (p< .0001). There were no significant differences between the two groups in fentanyl (p =0 .163) and ketorolac (p = 0.676) doses and PONV.
Conclusion: The analgesic effects of nefopam and fentanyl administered after LC in female patients were not significantly different. Nefopam is not inferior to fentanyl for pain control of LC.