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The effect of using nefopam in fentanyl-based intravenous patient-controlled analgesia on the incidence of postoperative nausea and vomiting in laparoscopic gynecological surgery
Med Biol Sci Eng 2021;4(1):20-26
Published online January 31, 2021
© 2021 Medical Biological Science and Engineering.

YoonJu Go, Jun-Young Chung, Jae-woo Yi, Bong-Jae Lee, Hyungseok Seo

Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
Correspondence to: Hyungseok Seo
Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
Tel: +82-2-440-7808
Fax: +82-2-440-7806
E-mail: seohyungseok@gmail.com
ORCID: https://orcid.org/0000-0003-4574-9122
Received December 1, 2020; Revised December 11, 2020; Accepted December 23, 2020.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Currently, the regimen of intravenous patient-controlled analgesia (IV-PCA) has become lowering opioid to reduce opioid-related side effects, particularly, postoperative nausea and vomiting (PONV). Using nefopam in IV-PCA may decrease the incidence of PONV, but there is still a lack of evidence. 178 patients undergoing laparoscopic gynecological surgery were randomly assigned into two groups. The IV-PCA regimen for group F was 20 mg/kg fentanyl and for group N was 10 mg/kg fentanyl with 200 mg of nefopam. The severity of PONV and pain were assessed at both 1 hour and 24 hours after surgery. Patients’ satisfaction with recovery was evaluated by a structured questionnaire. The incidence of PONV showed no statistical difference between group N and group F (28.2% vs. 26.8% at 1 hour, p=0.839 and 32.1% vs. 43.9% at 24 hours, p=0.120, respectively). Also, postoperative pain intensity showed no statistical difference between the two groups. Patient recovery was similar between the two groups. The combined use of nefopam in IV-PCA seems to effectively decrease the fentanyl dose in laparoscopic gynecological surgery. However, it did not contribute to decreasing the incidence of PONV.
Keywords : Patient-controlled analgesia; Fentanyl; Postoperative nausea and vomiting; Nefopam
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