title: Nefopam Reduces Dysesthesia after Percutaneous Endoscopic Lumbar Discectomy.
abstract: BACKGROUND
  Neuropathic pain, including paresthesia/dysesthesia in the lower extremities, always develops and remains for at least one month, to variable degrees, after percutaneous endoscopic lumbar discectomy (PELD). The recently discovered dual analgesic mechanisms of action, similar to those of antidepressants and anticonvulsants, enable nefopam (NFP) to treat neuropathic pain. This study was performed to determine whether NFP might reduce the neuropathic pain component of postoperative pain.
  
  
  METHODS
  Eighty patients, who underwent PELD due to herniated nucleus pulposus (HNP) at L4-L5, were randomly divided into two equal groups, one receiving NFP (with a mixture of morphine and ketorolac) and the other normal saline (NS) with the same mixture. The number of bolus infusions and the infused volume for 3 days were compared in both groups. The adverse reactions (ADRs) in both groups were recorded and compared. The neuropathic pain symptom inventory (NPSI) score was compared in both groups on postoperative days 1, 3, 7, 30, 60, and 90.
  
  
  RESULTS
  The mean attempted number of bolus infusions, and effective infused bolus volume for 3 days was lower in the NFP group for 3 days. The most commonly reported ADRs were nausea, dizziness, and somnolence, in order of frequency in the NFP group. The median NPSI score, and all 5 median sub-scores in the NFP group, were significantly lower than that of the NS group until postoperative day 30.
  
  
  CONCLUSIONS
  NFP significantly reduced the neuropathic pain component, including paresthesia/dysesthesia until 1 month after PELD. The common ADRs were nausea, dizziness, somnolence, and ataxia.
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.
authors.forename: Young Min
authors.initials: YM
authors.lastname: Ok
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Cheon
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Choi
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Chang
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.
authors.forename: Ho Myung
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Kim
keywords: Adverse drug reactions; Dysesthesia; Herniated discs; Intravenous infusion; Nefopam; Neuropathic pain; Percutaneous discectomy; Postoperative pain; Symptom assessment
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