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Perioperative Intravenous Nefopam on Pain Management and Ambulation after Open Spine Surgery: A Randomized Double-Blind Controlled Study – Lumbar Spinal Stenosis

This article summarizes a randomized double-blind controlled study that aimed to evaluate the effects of intravenous nefopam in reducing morphine consumption and postoperative pain, as well as improving recovery in patients undergoing open spine surgery. The study involved 100 patients who were randomized into two groups, with one group receiving intravenous nefopam and the control group receiving normal saline. The results showed no significant differences in morphine consumption and postoperative pain score between the two groups in the first 24 hours. However, the nefopam group had lower pain scores at the post-anesthesia care unit (PACU) and a shorter length of hospital stay (LOS) compared to the control group. The study concluded that perioperative intravenous nefopam can effectively reduce pain during the early postoperative period and contribute to shorter LOS in open spine surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal centre in UK

Published article

CONCLUSIONS: Perioperative intravenous nefopam demonstrated significant pain reduction during the early postoperative period and shortened LOS. Nefopam is considered safe and effective as a part of multimodal analgesia in open spine surgery.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Asian Spine J. 2023 Jul 6. doi: 10.31616/asj.2022.0358. Online ahead of print.ABSTRACTSTUDY DESIGN: This was a randomized double-blind controlled study.PURPOSE: This study was designed to evaluate the effects of intravenous nefopam regarding its ability to reduce morphine consumption and postoperative pain and improve recovery in patients undergoing open spine surgery.OVERVIEW OF LITERATURE: Multimodal analgesia, including,

Asian Spine J. 2023 Jul 6. doi: 10.31616/asj.2022.0358. Online ahead of print.

ABSTRACT

STUDY DESIGN: This was a randomized double-blind controlled study.

PURPOSE: This study was designed to evaluate the effects of intravenous nefopam regarding its ability to reduce morphine consumption and postoperative pain and improve recovery in patients undergoing open spine surgery.

OVERVIEW OF LITERATURE: Multimodal analgesia, including nonopioid medications, is essential for pain management in spine surgery. Evidence regarding the use of intravenous nefopam in open spine surgery as part of enhanced recovery after surgery is lacking.

METHODS: In this study, 100 patients undergoing lumbar decompressive laminectomy with fusion were randomized into two groups. The nefopam group received 20-mg intravenous nefopam diluted in 100-mL normal saline intraoperatively, followed by 80-mg nefopam diluted in 500-mL normal saline, administered as a continuous infusion postoperatively for 24 hours. The control group received an identical volume of normal saline. Postoperative pain was managed using intravenous morphine via patient-controlled analgesia. Morphine consumption in the first 24 hours was recorded as the primary outcome. Secondary outcomes, including postoperative pain score, postoperative function, and length of hospital stay (LOS), were assessed.

RESULTS: No statistically significant differences in the total morphine consumption and postoperative pain score in the first 24 hours postoperatively between the two groups. At the post-anesthesia care unit (PACU), the nefopam group demonstrated lower pain scores while at rest (p =0.03) and upon movement (p =0.02) than the normal saline group. However, the severity of postoperative pain between the two groups was similar from postoperative day 1 to day 3. LOS was significantly shorter in the nefopam group than in the control group (p <0.01). The time to first sitting and walking and PACU discharge between the two groups were comparable.

CONCLUSIONS: Perioperative intravenous nefopam demonstrated significant pain reduction during the early postoperative period and shortened LOS. Nefopam is considered safe and effective as a part of multimodal analgesia in open spine surgery.

PMID:37408291 | DOI:10.31616/asj.2022.0358

The London Spine Unit : top spinal centre in UK

Read the original publication:

Perioperative Intravenous Nefopam on Pain Management and Ambulation after Open Spine Surgery: A Randomized Double-Blind Controlled Study

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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Asian Spine J. 2023 Jul 6. doi: 10.31616/asj.2022.0358. Online ahead of print.ABSTRACTSTUDY DESIGN: This was a randomized double-blind controlled study.PURPOSE: This study was designed to evaluate the effects of intravenous nefopam regarding its ability to reduce morphine consumption and postoperative pain and improve recovery in patients undergoing open spine surgery.OVERVIEW OF LITERATURE: Multimodal analgesia, including

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