Efficacy of nefopam in postoperative pain management: A systematic review of opioid consumption

Previous research assessing the role of nefopam in postoperative pain management has yielded mixed results, with more evidence supporting a beneficial effect. This systematic review examines the efficacy of nefopam in reducing opioid consumption in postoperative patients and includes patient satisfaction measures and the frequency of adverse events. A comprehensive search strategy was performed in the following databases: PubMed, Web of Science, and Cochrane Library. Search terms used included “postoperative pain management” AND “nefopam”, “nefopam” AND “opioid consumption”, and “nefopam” AND “analgesia” OR “postoperative pain management”. Studies involving postoperative adult patients receiving nefopam and compared with a control group were included. A risk of bias assessment was performed using the Cochrane ROB-2 tool. 17 articles passed the inclusion criteria. Findings indicated that nefopam significantly reduces opioid consumption in postoperative patients by an average of 38%. The overall analgesic effect of nefopam was superior to that of opioids alone, with a good margin of safety and a high degree of satisfaction in most patients. Nausea, sweating, and postoperative tachycardia were common in the treatment groups. From the findings, the study concludes that nefopam is an effective adjunctive postoperative analgesic that has a significant positive impact on pain management and reduction of opioid consumption. The study was registered on PROSPERO (ID: CRD42022364446).