title: Nefopam as an adjunct to intravenous patient-controlled analgesia after renal transplantation: a randomised trial.
abstract: 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).
  
  
  CONCLUSIONS
  In combination with fentanyl PCA, nefopam reduced post-operative fentanyl consumption with superior analgesia after renal transplantation.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.|Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Huh
authors.affiliation: Department of Research Affairs, Biostatistics Collaboration Unit, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Roh
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.|Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Oh
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.|Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y S
authors.initials: YS
authors.lastname: Choi
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009340:Nefopam / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D009340:Nefopam