การศึกษาเปรียบเทียบ Nefopam และ Tramadol ต่อการระงับปวดหลังผ่าตัดในผู้ป่วยที่ได้รับการผ่าตัดถุงน้ำดีโดยใช้กล้อง: การศึกษาแบบสุ่มและมีกลุ่มควบคุม

Chompoonik Jiemjitpolchai; Chulalak  Pinwattana

Authors

Chompoonik Jiemjitpolchai Sawanpracharak Hospital
Chulalak Pinwattana Sawanpracharak Hospital

Keywords:

Laparoscopic cholecystectomy, post-operative pain, nefopam, tramadol

Abstract

Objective: To compare the effectiveness between nefopam vs. tramadol in reducing post-operative pain after laparoscopic cholecystectomy surgery at Sawanpracharak Hospital and to compare the incidence rate of side effects from these drugs.

Method: This was a prospective randomized controlled trial study. We enrolled patients between the ages of 18 and 65 who had laparoscopic cholecystectomy scheduled at Sawanpracharak Hospital between July 2023 and October 2023. There were seventy patients in total. These patients were split into two groups: thirty-five patients were in the Nefopam group, and thirty-five patients were in the Tramadol group. We compared and evaluated the efficacy of tramadol and nefopam in lowering post-operative pain following laparoscopic cholecystectomy surgery using the Numeric Rating Scale (NRS).

Results: The pain score was significantly lower in the Nefopam group than in the Tramadol group. The difference in mean NRS scores between the two groups was statistically significant at 30 min, three h, six h, 12 h, and 24 h after postoperatively (p-value<0.05). This study’s three most common side effects were nausea/vomiting, dizziness, and dry mouth. The Nefopam group had a statistically significant lower incidence of nausea and vomiting (25.7%) than the Tramadol group, which had a 51.4% incidence (p-value=0.03). The rest of the side effects in this study showed no statistically significant difference in the incidence of side effects in both groups.

Conclusion: Intravenous nefopam (20 mg) provided better post-operative pain relief and reduced the incidence of nausea and vomiting during the first twenty-four hours after laparoscopic cholecystectomy surgery when compared to 50 mg of tramadol.

Keywords: Laparoscopic cholecystectomy, post-operative pain, nefopam, tramadol

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