Korean J Clin Pharm.  2018 Dec;28(4):279-284. 10.24304/kjcp.2018.28.4.279.

Concurrent Use of Nefopam vs. Ketorolac with Opioid Analgesic for Post-operative Pain Management

• Kim YH
• Kim YW
• Choi KS
• Lee JH
• Lee E
• Kim S
• Choi Y
• Lee E

• KMID: 2437931
• DOI: http://doi.org/10.24304/kjcp.2018.28.4.279

Abstract

OBJECTIVE
To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital.
METHODS
A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected.
RESULTS
Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups.
CONCLUSION
Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for postoperative pain management in general surgery patients in South Korea.

Keyword

Nefopam; ketorolac; postoperative pain management; analgesic effects; drug safety; adverse events; opioid analgesics

MeSH Terms

Analgesia, Patient-Controlled
Analgesics, Opioid
Drug-Related Side Effects and Adverse Reactions
Electronic Health Records
Fentanyl
Hand
Hospitals, Teaching
Humans
Ketorolac*
Korea
Nefopam*
Pain Management*
Pain, Postoperative
Paresthesia
Passive Cutaneous Anaphylaxis
Prescriptions
Product Labeling
Retrospective Studies
Analgesics, Opioid
Fentanyl
Ketorolac
Nefopam