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Home / Medicine, Volume 97, Number 10

Open Access The efficacy and safety of nefopam for pain relief during laparoscopic cholecystectomy

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Authors: Zhao, Tiancheng 1 ; Shen, Zhen 2 ; Sheng, Shihou 2 ; Yang., Feng

Source: Medicine, Volume 97, Number 10, March 2018, pp. e0089-e0089(1)

Publisher: Wolters Kluwer

DOI: https://doi.org/10.1097/MD.0000000000010089

Background:

Pain control after laparoscopic cholecystectomy (LC) has become an important topic. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of nefopam for pain management after LC.Methods:

PubMed, Medline, Embase, ScienceDirect, and the Cochrane Library were searched up to November 2017 for comparative articles involving nefopam and placebo for reducing postoperative pain after LC. Primary outcomes were postoperative pain scores and opioid consumption. Secondary outcomes were length of hospital stay, opioid-related adverse effects, and postoperative complications. We assessed statistical heterogeneity for each RCT by using a standard Chi2 test and the I 2 statistic. The meta-analysis was undertaken using Stata 12.0.Results:

A total of 215 patients were analyzed across 4 RCTs. We found that there were significant differences between nefopam and placebo groups regarding the postoperative pain scores and opioid requirements at 6, 12, and 24 hours. Moreover, there was a decreased risk of opioid-related adverse effects in the nefopam groups. No significant differences were identified in terms of the incidence of postoperative complications.Conclusion:

Intravenous nefopam infusion resulted in significant reduction in postoperative pain scores and opioid requirements while decreasing opioid-related adverse effects. Additionally, no increased risk of venous thromboembolism was found. The current evidence suggests that more RCTs will be needed in further investigations.

Keywords: laparoscopic cholecystectomy; meta-analysis; nefopam; pain management

Document Type: Research Article

Affiliations: 1: Department of Endoscopy Center 2: Department of Gastrointestinal Surgery, China–Japan Union Hospital of Jilin University, Jilin, China.

Publication date: 01 March 2018

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