The Analgesic Effect of Nefopam in Patients Undergoing Orthopedics Surgery with Tourniquet: a Double-blind Case-control Trial.

Background: Pain-free and relief are one of the anesthesiologist's most important concerns during the operation. General aim is always to effectively control pain but while simultaneously reducing opioid requirements to reduce opioid related side effects and mortality. Patients undergoing orthopedic operations tend to have high pain scores and analgesic requirements. Objective: In this study, we aim to investigate the effect of adding nefopam on reducing the postoperative pain scores and the need for opioids. Methods: This double-blind placebo-controlled prospective study aims to determine the effectiveness of nefopam in relieving the pain resulting from the operation in addition to the pain resulting from tourniquet. The unlabeled drug solution was administered one at the beginning of surgery. A 10 mL solution containing nefopam 20 mg or placebo diluted with normal saline was infused over 20 min. 11-point visual analogue scale was utilized to assess the pain score. Results: Forty-nine participants enrolled in the study, 24 received nefopam. The mean age was 40.45 years. Participants received nefopam achieved better postoperative surgical site pain score, less intraoperative and postoperative opioids use. Nefopam utilization was the single independent factor affecting the postoperative pain score. Conclusions: Compared with placebo, opioid requirement was decreased, the pain resulting from operation and tourniquet pain were decreased.