The Korean Journal of Pain

  • 제31권2호
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  • Pages.102-108
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  • 2018
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  • 2005-9159(pISSN)
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  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
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Effects of warmed carrier fluid on nefopam injection-induced pain

  • Cho, Hyung Rae (Department of Anesthesiology and Pain Medicine, Myongji Hospital) ;
  • Kim, Seon Hwan (Department of Anesthesiology and Pain Medicine, Myongji Hospital) ;
  • Kim, Jin A (Department of Anesthesiology and Pain Medicine, Myongji Hospital) ;
  • Min, Jin Hye (Department of Anesthesiology and Pain Medicine, Myongji Hospital) ;
  • Lee, Yong Kyung (Department of Anesthesiology and Pain Medicine, Myongji Hospital)
  • 투고 : 2017.12.01
  • 심사 : 2018.02.27
  • 발행 : 2018.04.01
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초록

Background: Nefopam is a non-opioid, non-steroidal analgesic drug with fewer adverse effects than narcotic analgesics and nonsteroidal anti-inflammatory drugs, and is widely used for postoperative pain control. Because nefopam sometimes causes side effects such as nausea, vomiting, somnolence, hyperhidrosis and injection-related pain, manufacturers are advised to infuse it slowly, over a duration of 15 minutes. Nevertheless, pain at the injection site is very common. Therefore, we investigated the effect of warmed carrier fluid on nefopam injection-induced pain. Methods: A total of 48 patients were randomly selected and allocated to either a control or a warming group. Warming was performed by diluting 40 mg of nefopam in 100 ml of normal saline heated to $31-32^{\circ}C$ using two fluid warmers. The control group was administered 40 mg of nefopam dissolved in 100 ml of normal saline stored at room temperature ($21-22^{\circ}C$) through the fluid warmers, but the fluid warmers were not activated. Results: The pain intensity was lower in the warming group than in the control group (P < 0.001). The pain severity and tolerance measurements also showed statistically significant differences between groups (P < 0.001). In the analysis of vital signs before and after the injection, the mean blood pressure after the injection differed significantly between the groups (P = 0.005), but the heart rate did not. The incidence of hypertension also showed a significant difference between groups (P = 0.017). Conclusions: Use of warmed carrier fluid for nefopam injection decreased injection-induced pain compared to mildly cool carrier fluid.

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참고문헌

  1. Girard P, Chauvin M, Verleye M. Nefopam analgesia and its role in multimodal analgesia: a review of preclinical and clinical studies. Clin Exp Pharmacol Physiol 2016; 43: 3-12. https://doi.org/10.1111/1440-1681.12506
  2. Kim YM, Lim BG, Kim H, Kong MH, Lee MK, Lee IO. Slow injection of nefopam reduces pain intensity associated with intravenous injection: a prospective randomized trial. J Anesth 2014; 28: 399-406. https://doi.org/10.1007/s00540-013-1744-z
  3. Dordoni PL, Della Ventura M, Stefanelli A, Iannace E, Paparella P, Rocca B, et al. Effect of ketorolac, ketoprofen and nefopam on platelet function. Anaesthesia 1994; 49: 1046-9. https://doi.org/10.1111/j.1365-2044.1994.tb04352.x
  4. Bhatt AM, Pleuvry BJ, Maddison SE. Respiratory and metabolic effects of oral nefopam in human volunteers. Br J Clin Pharmacol 1981; 11: 209-11.
  5. Evans MS, Lysakowski C, Tramer MR. Nefopam for the prevention of postoperative pain: quantitative systematic review. Br J Anaesth 2008; 101: 610-7. https://doi.org/10.1093/bja/aen267
  6. Piercey MF, Schroeder LA. Spinal and supraspinal sites for morphine and nefopam analgesia in the mouse. Eur J Pharmacol 1981; 74: 135-40. https://doi.org/10.1016/0014-2999(81)90523-9
  7. Heel RC, Brogden RN, Pakes GE, Speight TM, Avery GS. Nefopam: a review of its pharmacological properties and therapeutic efficacy. Drugs 1980; 19: 249-67. https://doi.org/10.2165/00003495-198019040-00001
  8. Durrieu G, Olivier P, Bagheri H, Montastruc JL. Overview of adverse reactions to nefopam: an analysis of the French Pharmacovigilance database. Fundam Clin Pharmacol 2007; 21: 555-8. https://doi.org/10.1111/j.1472-8206.2007.00499.x
  9. Jung KT, Kim HJ, Bae HS, Lee HY, Kim SH, So KY, et al. Effects of lidocaine, ketamine, and remifentanil on withdrawal response of rocuronium. Korean J Anesthesiol 2014; 67: 175-80. https://doi.org/10.4097/kjae.2014.67.3.175
  10. Polat R, Aktay M, Ozlu O. The effects of remifentanil, lidocaine, metoclopramide, or ketamine pretreatment on propofol injection pain. Middle East J Anaesthesiol 2012; 21: 673-7.
  11. Alipour M, Tabari M, Alipour M. Paracetamol, ondansetron, granisetron, magnesium sulfate and lidocaine and reduced propofol injection pain. Iran Red Crescent Med J 2014; 16: e16086.
  12. Mahajan C, Rath GP, Bithal PK, Prabhakar H, Yadav R, Dube SK. Local warming at injection site helps alleviate pain after rocuronium administration. J Anesth 2010; 24: 845-8. https://doi.org/10.1007/s00540-010-1014-2
  13. Jeong M, Yoon H. Comparison of the effects of lidocaine pre-administration and local warming of the intravenous access site on propofol injection pain: randomized, doubleblind controlled trial. Int J Nurs Stud 2016; 61: 209-18. https://doi.org/10.1016/j.ijnurstu.2016.06.012
  14. Youn AM, Hsu TM. Heated carrier fluids in decreasing propofol injection pain: a randomized, controlled trial. Korean J Anesthesiol 2017; 70: 33-8.
  15. Kim DJ, Kim SH, So KY, An TH. Mega Acer $Kit^{(R)}$ is more effective for warming the intravenous fluid than $Ranger^{(TM)}$ and $ThermoSens^{(R)}$ at 440 ml/h of infusion rate: an experimental performance study. Korean J Anesthesiol 2017; 70: 456-61.
  16. Klement W, Arndt JO. Pain on i.v. injection of some anaesthetic agents is evoked by the unphysiological osmolality or pH of their formulations. Br J Anaesth 1991; 66: 189-95. https://doi.org/10.1093/bja/66.2.189
  17. Gregori-Puigjane E, Setola V, Hert J, Crews BA, Irwin JJ, Lounkine E, et al. Identifying mechanism-of-action targets for drugs and probes. Proc Natl Acad Sci U S A 2012; 109: 11178-83. https://doi.org/10.1073/pnas.1204524109
  18. Raote I, Bhattacharya A, Panicker MM. Serotonin 2A (5-HT2A) receptor function: ligand-dependent mechanisms and pathways. In: Serotonin receptors in neurobiology. Edited by Chattopadhyay A. Boca Raton (FL), CRC Press. 2007, pp 105-32.
  19. Kaplanski G, Porat R, Aiura K, Erban JK, Gelfand JA, Dinarello CA. Activated platelets induce endothelial secretion of interleukin-8 in vitro via an interleukin-1-mediated event. Blood 1993; 81: 2492-5.
  20. Neumann FJ, Marx N, Gawaz M, Brand K, Ott I, Rokitta C, et al. Induction of cytokine expression in leukocytes by binding of thrombin-stimulated platelets. Circulation 1997; 95: 2387-94.
  21. Christen S, Delachaux A, Dischl B, Golay S, Liaudet L, Feihl F, et al. Dose-dependent vasodilatory effects of acetylcholine and local warming on skin microcirculation. J Cardiovasc Pharmacol 2004; 44: 659-64.
  22. Minson CT, Berry LT, Joyner MJ. Nitric oxide and neurally mediated regulation of skin blood flow during local heating. J Appl Physiol (1985) 2001; 91: 1619-26. https://doi.org/10.1152/jappl.2001.91.4.1619
  23. Taylor WF, Johnson JM, O'Leary D, Park MK. Effect of high local temperature on reflex cutaneous vasodilation. J Appl Physiol Respir Environ Exerc Physiol 1984; 57: 191-6.
  24. Elstad M, Vanggaard L, Lossius AH, Walloe L, Bergersen TK. Responses in acral and non-acral skin vasomotion and temperature during lowering of ambient temperature. J Therm Biol 2014; 45: 168-74. https://doi.org/10.1016/j.jtherbio.2014.09.003
  25. Bergersen TK, Skytioti M, Elstad M. Cold-induced sympathetic tone modifies the impact of endothelium-dependent vasodilation in the finger pulp. Auton Neurosci 2017; 203: 97-102. https://doi.org/10.1016/j.autneu.2016.11.004
  26. Hagemann K, Platte G, Meyer J, Effert S. Haemodynamic effects of nefopam (author's transl). Dtsch Med Wochenschr 1978; 103: 1040-3. https://doi.org/10.1055/s-0028-1104830
  27. Sacco M, Meschi M, Regolisti G, Detrenis S, Bianchi L, Bertorelli M, et al. The relationship between blood pressure and pain. J Clin Hypertens (Greenwich) 2013; 15: 600-5. https://doi.org/10.1111/jch.12145