Korean J Health Promot.  2024 Jun;24(2):56-66. 10.15384/kjhp.2024.00052.

Effects of Intravenous Nefopam on Pain Relief in Patients with Acute Postoperative Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

• JIN Y
• MYUNG SK
• KANG H
• EOM W
• KIM D

• KMID: 2557077
• DOI: http://doi.org/10.15384/kjhp.2024.00052

Abstract

Background
Although intravenous nefopam has been used for opioid-sparing strategy and pain relief, randomized controlled trials (RCTs) have shown inconsistent findings.
Methods
We searched core databases, PubMed, EMBASE, and the Cochrane library for RCTs on this research question in December 2022. Standardized mean difference (SMD) and weighted mean difference (WMD) were calculated using a random-effects meta-analysis.
Results
Of 708 studies identified from the databases, a total of 17 RCTs (n=1,173 patients) that met the inclusion criteria were included in the final meta-analysis. Overall, the consumption of cumulative opioid analgesics was significantly lower in the nefopam group than the control group, on arrival in the postanesthesia care unit (PACU) (SMD, −0.70; 95% confidence interval [CI], −1.01 to −0.39; I2= 55.1%; n=7), at 24 hours (SMD, −0.65; 95% CI, −1.09 to −0.20; I2=87.4%; n=9), and 48 hours (SMD, −0.82; 95% CI, −1.40 to −0.24; I2=85.6%; n=6) after surgery. It also showed a significant lower pain score, on arrival in the PACU (WMD, −0.80; 95% CI, −1.27 to −0.32; I2=69.6%; n=7) and 24 hours (WMD, −0.48; 95% CI, −0.79 to −0.16; I2=0.0%, n=5). However, publication bias was observed (asymmetrical funnel plot and P for bias=0.005).
Conclusions
Intravenous nefopam showed an opioid-sparing effect and pain relief in the management of patients with acute postoperative pain.

Keyword

Nefopam; Pain relief; Randomized controlled trial; Meta-analysis