Korean J Anesthesiol.  2017 Dec;70(6):612-618. 10.4097/kjae.2017.70.6.612.

A comparison between ketorolac and nefopam as adjuvant analgesics for postoperative patient-controlled analgesia: a randomized, double-blind, prospective study

• Son JS
• Doo A
• Kwon YJ
• Han YJ
• Ko S

• KMID: 2395670
• DOI: http://doi.org/10.4097/kjae.2017.70.6.612

Abstract

BACKGROUND
We compared the analgesic efficacy and side effects of ketorolac and nefopam that were co-administered with fentanyl via intravenous patient-controlled analgesia.
METHODS
One hundred and sixty patients scheduled for laparoscopic cholecystectomy were randomly assigned to ketorolac (Group K) or nefopam (Group N) groups. The anesthetic regimen was standardized for all patients. The analgesic solution contained fentanyl 600 µg and ketorolac 180 mg in Group K, and fentanyl 600 µg and nefopam 120 mg in Group N. The total volume of analgesic solution was 120 ml. Postoperative analgesic consumption, recovery of pulmonary function, and pain intensities at rest and during the forced expiration were evaluated at postoperative 2, 6, 24, and 48 h. The postoperative side effects of analgesics were recorded.
RESULTS
Cumulative postoperative analgesic consumptions at postoperative 48 h were comparable (Group K: 93.4 ± 24.0 ml vs. Group N: 92.9 ± 26.1 ml, P = 0.906) between the groups. Pain scores at rest and during deep breathing were similar at the time of each examination. The recovery of pulmonary function showed no significant differences between the groups. Overall, postoperative nausea and vomiting incidence was higher in Group N compared with Group K (59% vs. 34%, P = 0.015). The other side effects were comparable between both groups.
CONCLUSIONS
Analgesic efficacies of ketorolac and nefopam that were co-administered with fentanyl for postoperative pain management as adjuvant analgesics were similar. However, postoperative nausea and vomiting incidence was higher in the nefopam-fentanyl combination compared with the ketorolac-fentanyl combination.

Keyword

Ketorolac; Nefopam; Patient-controlled analgesia; Postoperative pain

MeSH Terms

Analgesia, Patient-Controlled*
Analgesics*
Cholecystectomy, Laparoscopic
Fentanyl
Humans
Incidence
Ketorolac*
Nefopam*
Pain, Postoperative
Postoperative Nausea and Vomiting
Prospective Studies*
Respiration
Analgesics
Fentanyl
Ketorolac
Nefopam