Assessment of the morphine-sparing effect and analgesic efficacy of nefopam after colorectal surgery in cancer patients

Introduction. The study presents data regarding nefopam efficacy in the treatment of postoperative pain in cancer patients after colorectal surgery with an evaluation of adverse side effects. Material and methods. 3 2 cancer patients after colorectal surgery were included into the study. Central randomization was used. In the control group (n=16) patients received morphine intravenously by a patient‐ controlled analgesia pump (PCA). In the treatment group (n=16) patients received additional analgesia with nefopam 20 mg intramusculary every 6 hours. Morphine consumption and postoperative pain intensity assessment acc. to the visual‐analogue scale (VAS) were compared during a 24‐hour observation period. Adverse side effects, serum transaminase levels, return of intestinal peristalsis and the hospitalization time were also evaluated. Results. We observed statistically significant lower morphine consumption in the treatment group. The incidence of dry mouth, headache, dizziness, drowsiness and shivering were similar in both groups. Sweating was recorded more often in the group treated with nefopam and the difference was statistically significant. We did not observe significant differences in the median values of other measured parameters. Conclusions. Our findings suggest that the combination of nefopam and parenteral morphine can be used for the treatment of postoperative pain. It is important to remember the contraindications for nefopam use, such as concurrent administration of monoamine oxidase inhibitors, antidepressants, epilepsy, glaucoma, coronary artery disease and tachycardia.