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http://dx.doi.org/10.24304/kjcp.2018.28.4.279

Concurrent Use of Nefopam vs. Ketorolac with Opioid Analgesic for Post-operative Pain Management  

Kim, Yoon Hee (Department of Pharmacy, Seoul National University Bundang Hospital)
Kim, Young Won (College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University)
Choi, Kyung Suk (Department of Pharmacy, Seoul National University Bundang Hospital)
Lee, Jung Hwa (Department of Pharmacy, Seoul National University Bundang Hospital)
Lee, Eunsook (Department of Pharmacy, Seoul National University Bundang Hospital)
Kim, Seungyeon (College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University)
Choi, YoungRok (General Surgery Center, Seoul National University Bundang Hospital)
Lee, Euni (College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University)
Publication Information
Korean Journal of Clinical Pharmacy / v.28, no.4, 2018 , pp. 279-284 More about this Journal
Abstract
Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.
Keywords
Nefopam; ketorolac; postoperative pain management; analgesic effects; drug safety; adverse events; opioid analgesics;
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