Analgesic efficacy and safety of nefopam vs. propacetamol following hepatic resection

In order to compare the morphine-sparing effect, analgesic efficacy and tol erance of nefopam and propacetamol given at their highest recommended doses , 120 patients undergoing elective hepatic resection were randomly assigned to receive postoperative intravenous patient-controlled analgesia with mor phine alone, or in combination with nefopam (20 mg.4 h(-1)) or propacetamol (2 g.6 h(-1)). Compared with the control group (43 [7-92] mg), median [ran ge] cumulative morphine consumption for 24 h after the study started was ha lved in the nefopam group (21 [3-78] mg, p < 0.001) and 20% lower in the pr opacetamol group (35 [6-84] mg, p = 0.15). Analgesia was superior in the ne fopam group despite the lower morphine consumption. Adverse effects were co mparable in the three groups, except for significantly more nausea in the c ontrol group (39% vs. 17 and 26% in the nefopam and propacetamol groups, re spectively) and more sweating in the nefopam group (17% vs. 0 and 3% in the control and propacetamol groups, respectively). Overall patient satisfacti on was better (p < 0.001) in patients given nefopam (97%) than those receiv ing morphine alone (82%) or propacetamol (74%).