SynthesisEuropean journal of clinical pharmacology2026
The safety and efficacy of peri-operative nefopam for analgesia in hip and knee arthroplasty: A systematic review and meta-analysis.
Synthesis in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
purposeOpioid-related adverse effects have prompted interest in opioid-sparing strategies in joint arthroplasty. This systematic review evaluates the safety and efficacy of perioperative nefopam, a non-opioid, non-NSAID analgesic, in patients undergoing hip and knee arthroplasty.
methodsMedline, Cochrane, Embase, and Scopus were searched from database inception to September 2025. For meta-analysis, continuous outcomes were pooled as mean differences (MD) with 95% confidence intervals (CI), and dichotomous outcomes as risk ratios (RR). Certainty of evidence was assessed using GRADE.
resultsFour unique randomised control trials (n = 425) were included. Nefopam was not associated with significant reductions in opioid consumption at 24 h (4 studies, 425 patients, MD - 6.73 mg; 95% CI - 18.56 to 5.09 mg; GRADE: +). However, nefopam significantly reduced pain during movement at 24 h (3 studies, 225 patients, MD - 8.24; 95% CI - 13.52 to - 2.96; GRADE: +++) but not 24-hour pain score at rest (4 studies, 425 patients; MD -4.96; 95% CI -12.78 to 2.87; GRADE: +). Nefopam was also associated with improved knee range of motion at 24 h postoperatively (2 studies, 177 patients, MD 7.78°; 95% CI 7.33° to 8.24°; GRADE: +++). No significant differences were observed for length of hospital stay, patient satisfaction, or adverse-event outcomes.
conclusionNefopam reduced pain during movement and improved early knee range of motion at 24 h but did not reduce acute opioid consumption or drug-related adverse effects after hip or knee arthroplasty.
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