title: Opioid sparing effect and safety of nefopam in patient controlled analgesia after laparotomy: A randomized, double blind study.
abstract: OBJECTIVE
  A double-blind randomised study to evaluate the opioid sparing effect and safety of nefopam when administered via intravenous patient controlled analgesia (PCA) with fentanyl.
  
  
  METHODS
  Patients planned for elective open laparotomy, were randomly assigned to receive into fentanyl 25 µg/ml (SF group) or nefopam 2.4 mg/ml plus fentanyl 25 µg/ml (NF group). Patients were assessed before surgery and for 24 h postoperatively.
  
  
  RESULTS
  Total PCA fentanyl consumption was significantly lower in the NF group (n = 35) than the SF group (n = 36). Pain scores were significantly lower and patients' satisfaction with treatment significantly better in the NF group than the SF group. Dry mouth and dizziness were significantly more frequent in the NF group than the SF group. There were no other statistically significant between-group differences in the incidence of adverse events.
  
  
  CONCLUSIONS
  Intravenous PCA using nefopam + fentanyl following laparotomy has an opioid sparing effect and is associated with a low incidence of some of the typical opioid related adverse events.
  
  
  BACKGROUND
  Clinicaltrials.gov Registration No: NCT02596269.
authors.affiliation: Department of Anaesthesia and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hyun Seung
authors.initials: HS
authors.lastname: Jin
authors.affiliation: Department of Anaesthesia and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea pain@snu.ac.kr.
authors.forename: Yong Chul
authors.initials: YC
authors.lastname: Kim
authors.affiliation: Department of Anaesthesia and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Yongjae
authors.initials: Y
authors.lastname: Yoo
authors.affiliation: Department of Anaesthesia and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Changsoon
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Anaesthesia and Pain Medicine, Seoul National University Bundang Hospital, Kyunggi-do, Republic of Korea.
authors.forename: Chan Woo
authors.initials: CW
authors.lastname: Cho
authors.affiliation: Department of Anaesthesia and Pain Medicine, School of Medicine, Ewha Woman's University, Seoul, Republic of Korea.
authors.forename: Won-Joong
authors.initials: WJ
authors.lastname: Kim
mesh_terms: D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000494:pharmacology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009340:Nefopam / Q000009:adverse effects* / Q000494:pharmacology*; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D017060:Patient Satisfaction
chemical_list: D000701:Analgesics, Opioid; D009340:Nefopam; D005283:Fentanyl
keywords: Adverse events; fentanyl; opioid sparing; laparotomy; nefopam; patient controlled analgesia