Publication: Morphine-Sparing Effect of Intermittent Versus Continuous Intravenous Infusion of Nefopam in Patients After Total Knee Arthroplasty: A Randomized Trial
Issued Date
2024
Resource Type
Resource Version
Accepted Manuscript
Language
eng
File Type
application/pdf
ISSN
0125-3611 (Print)
2651-0561 (Online)
2651-0561 (Online)
Journal Title
Ramathibodi Medical Journal
Volume
47
Issue
3
Start Page
12
End Page
21
Access Rights
open access
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ผลงานนี้เป็นลิขสิทธิ์ของมหาวิทยาลัยมหิดล ขอสงวนไว้สำหรับเพื่อการศึกษาเท่านั้น ต้องอ้างอิงแหล่งที่มา ห้ามดัดแปลงเนื้อหา และห้ามนำไปใช้เพื่อการค้า
Rights Holder(s)
Pharmacy Division Faculty of Medicine Ramathibodi Hospital Mahidol University
Department of of Pharmacy Practice Faculty of Pharmaceutical Sciences Chulalongkorn University
Department of Orthopaedics Faculty of Medicine Ramathibodi Hospital Mahidol University
Department of Anesthesiology Faculty of Medicine Ramathibodi Hospital Mahidol University
Department of of Pharmacy Practice Faculty of Pharmaceutical Sciences Chulalongkorn University
Department of Orthopaedics Faculty of Medicine Ramathibodi Hospital Mahidol University
Department of Anesthesiology Faculty of Medicine Ramathibodi Hospital Mahidol University
Bibliographic Citation
Ramathibodi Medical Journal. Vol. 47, No. 3 (Jul - Jun 2024), 12-21
Suggested Citation
Woratanat Kachacheewa, Thitima Wattanavijitkul, Siwadol Wongsak, Theerawat Chalacheewa Morphine-Sparing Effect of Intermittent Versus Continuous Intravenous Infusion of Nefopam in Patients After Total Knee Arthroplasty: A Randomized Trial. Ramathibodi Medical Journal. Vol. 47, No. 3 (Jul - Jun 2024), 12-21. 21. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/110056
Research Projects
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Authors
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Thesis
Title
Morphine-Sparing Effect of Intermittent Versus Continuous Intravenous Infusion of Nefopam in Patients After Total Knee Arthroplasty: A Randomized Trial
Author's Affiliation
Mahidol University. Faculty of Medicine Ramathibodi Hospital. Pharmacy Division
Chulalongkorn University. Faculty of Pharmaceutical Sciences. Department of of Pharmacy Practice
Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Orthopaedics
Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Anesthesiology
Chulalongkorn University. Faculty of Pharmaceutical Sciences. Department of of Pharmacy Practice
Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Orthopaedics
Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Anesthesiology
Abstract
Background: Nefopam, a nonopioid analgesic, is recommended to improve pain control and minimize opioid-related side effects following total knee arthroplasty (TKA).
Objective: To compare cumulative morphine consumption between intermittent infusion (II) and continuous infusion (CI) of nefopam, combined with other multimodal analgesics, in TKA patients.
Methods: Fifty-eight patients were randomly assigned to receive either intermittent nefopam infusion (II group) (20 mg IV every 6 hours) or continuous infusion (CI group) (80 mg/day). The primary outcome was cumulative morphine consumption via patient-controlled analgesia, with secondary outcomes including pain scores every 4 hours and adverse drug reactions (ADRs).
Results: No significant difference was found in cumulative morphine consumption (median [range], 4 [0 -12] mg in II and 6 [0 - 18] mg in CI; P = .579) and the ADRs over 48 hours between groups. At 4 hours, the II group had significantly lower pain scores compared to the CI group (median [range], 0 [0 - 4] and 0 [0 - 8]; P = .008). However, by 24 and 36 hours, the CI group reported significantly lower pain scores compared to the II group; median (range), 0 (0 - 5) vs 2 (0 - 9) at 24 hours (P = .020) and 0 (0 - 4) vs 2 (0 - 8) at 36 hours (P = .014).
Conclusions: Both intermittent and continuous nefopam infusion in primary TKA showed no significant difference in morphine-sparing or occurrence of ADRs within the 48-hour follow-up period. These findings suggest that both infusion methods are comparable in managing post-operative pain in TKA patients.