ESRA Academy. Choi E. Sep 8, 2016; 138451; 0302 Topic: PAIN THERAPY (ACUTE - CHRONIC)
Prof. Dr. Eunsu Choi
Prof. Dr. Eunsu Choi

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Background and Aims:

Catheter-related bladder discomfort (CRBD) due to intraoperative catheterization of urinary bladder is one of the most distressing symptoms during recovery from anesthesia. Nefopam, a centrally-acting non-opioid analgesic drug, is effective for relieving the acute and chronic pain. Also, it has been shown to have anticholinergic actions. The aim of this study was to assess the effects of nefopam for CRBD after nephrectomy.


Adult male patients undergoing nephrectomy requiring urinary bladder catheterization intraoperatively were enrolled and randomized into two groups. The control group (n=15) received normal saline and the nefopam group (n=15) was administered nefopam 20 mg i.v  during 1 hour before the end of surgery. Induction and maintenance of anesthesia were standardized. The severity of CRBD, postoperative pain, and adverse effects were assessed at 20 min, 1, 2, and 6 h after the end of surgery.


The severity of CRBD observed in the nefopam group was significantly lower than that of the control group at 20 min, 1, 2, and 6 h after administration of the study drug [31(6), 37 (6), 24 (5), 24 (5)in the control group vs 28 (8), 27 (9), 20 (1) 20 (1)in the nefopam group, P = 0.046, 0.010, <0.01, and <0.01]. Rescue analgesics were required less in the nefopam group than in the control group (P<0.01). Adverse events were comparable between the two groups.


Nefopam 20 mg administered i.v. before the end of surgery reduced both the severity of CRBD and the need for rescue analgesics without adverse effects in patients undergoing nephrectomy.

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