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

수술 후 통증조절 목적으로 펜타닐과 병용되는 네포팜 vs. 케토롤락의 사용현황

  • 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)
  • 김윤희 (분당서울대학교병원 약제부) ;
  • 김영원 (서울대학교 약학대학) ;
  • 최경숙 (분당서울대학교병원 약제부) ;
  • 이정화 (분당서울대학교병원 약제부) ;
  • 이은숙 (분당서울대학교병원 약제부) ;
  • 김승연 (서울대학교 약학대학) ;
  • 최영록 (분당서울대학교병원 외과) ;
  • 김은경 (서울대학교 약학대학)
  • Received : 2018.11.27
  • Accepted : 2018.12.11
  • Published : 2018.12.29

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

References

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