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Concurrent Use of Nefopam vs. Ketorolac with Opioid Analgesic for Post-operative Pain Management
Korean J Clin Pharm 2018;28(4):279-284
Published online December 31, 2018
© 2018 Korean College of Clinical Pharmacy.

Yoon Hee Kim, Young Won Kim, Kyung Suk Choi1&, Jung Hwa Lee1&, Eunsook Lee1&, Seungyeon Kim2, YoungRok Choi3*, and Euni Lee2*

1Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Republic of Korea
2College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
3General Surgery Center, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Republic of Korea
Correspondence to: Euni Lee, College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, 1, Gwanakro, Gwanak-gu, Seoul 08826, Republic of Korea Tel: +82-2-740-8588, Fax: +82-2-880-9122 E-mail: eunilee@snu.ac.kr
*Co-corresponding Author: YoungRok Choi, General Surgery Center, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beongil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea E-mail: choiyoungrok@gmail.com
These authors contributed equally to this work.
&These authors also contributed equally to this work.
Received November 27, 2018; Revised December 10, 2018; Accepted December 11, 2018.
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
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 postoperative pain management in general surgery patients in South Korea.
Keywords : Nefopam, ketorolac, postoperative pain management, analgesic effects, drug safety, adverse events, opioid analgesics


December 2018, 28 (4)
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