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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(04): e261-e266
DOI: 10.1055/s-0043-1776887
Original Article

Postoperative Analgesic Efficacy of Nefopam after Anorectal Surgery: A Retrospective Observational Study

Phantila Haruethaivijitchock 
1   Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
,
Tasneem Cha-arong 
2   Department of Anesthesiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
,
Suwapit Jungprasert 
2   Department of Anesthesiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
,
Thanapoom Rattananupong 
3   Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
,
Vitool Lohsoonthorn 
3   Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
› Institutsangaben
Funding The authors have no sources of funding to declare for this manuscript.
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Abstract

Objective To examine the effectiveness of nefopam on postoperative pain control after anorectal surgeries.

Methods We retrospectively reviewed the electronic medical records of patients who underwent anorectal surgeries from January 2019 to March 2022 at two medical centers. The data were divided into nefopam and conventional groups. The primary outcome was the number of patients who requested additional opioids in the 24-h postoperative period. The secondary outcomes were numeric rating pain scores (NRPS) within a 24-h postoperative period and analgesic drugs-related side effects.

Results Eighty-seven patients in the conventional group and 60 in the nefopam group were recruited. The nefopam group reported less additional opioid consumption than the conventional group in all dimensions of analysis, including overall, adjusted to anesthetic techniques and types of surgery. However, these did not reach statistical significance (P = 0.093). Only patients in the nefopam group who underwent hemorrhoidectomy under TIVA or spinal anesthesia significantly required fewer additional opioids (P = 0.016, 60% mean difference). Similarly, the 24-h postoperative morphine consumption was lower in the nefopam group (mean difference = −3.4, 95%CI: 0.72,6.08). Furthermore, significantly lower NRPS were reported in the nefopam group during the 12-18 h postoperative period (P = 0.009). On the other hand, analgesic drugs related side effects were similar in both groups.

Conclusions The administration of nefopam after major anorectal surgery is beneficially evident in reducing postoperative opioid requirements.

Keywords

anorectal surgery - hemorrhoidectomy - nefopam - postoperative pain - opioid requirements


Publikationsverlauf

Eingereicht: 24. März 2023

Angenommen: 24. Oktober 2023

Artikel online veröffentlicht:
27. November 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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