Nefopam and tramadol for the prevention of shivering during neuraxial anesthesia

Bilotta, Federico; Pietropaoli, P; Sanitá, Raffaele; G, Liberatori; Rosa, Giovanni

doi:10.1097/00115550-200207000-00008

Cited by 10 publications

(11 citation statements)

References 15 publications

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“…In accordance with the present study, intravenous nefopam 0.15 mg/kg compared to 0.5 mg/kg intravenous tramadol showed a promising effect in the control shivering after mepivacaine 1 mg/kg epidurally or 0.2 mg/kg in subarachnoid block [12]. Controversially, when compared to nefopam, Röhm et al [11] reported that physostigmine superiorly reduced both incidence and severity of post general anesthetic shivering.…”

Section: Discussionsupporting

confidence: 88%

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The Effect of Oral Pregabalin on Epidural-Induced Shivering and Epidural Characteristics in Gynecological Surgeries, a Prospective Randomized Double-Blind Study

Menesy¹,

Adel²,

Badawy³

et al. 2018

Preprint

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Purpose: The previous reports tried to reduce shivering and improve neuraxial anesthesia characteristics by the systemic use of different drugs. This study was directed to evaluate the effect of pregabalin premedication on both shivering and epidural characteristics following single shot loading. Patients and Methods: Eighty female patients, ASA grade I and II, scheduled for gynecological surgeries under epidural anesthesia were studied. The patients were divided into two groups: Pregabalin (P) group and Control (C) group in which the patients received 150 mg of pregabalin and placebo capsules respectively sixty minutes prior to surgery. Following epidural loading, the onset and degree of shivering were compared between the two groups. Also, the epidural onset, level and duration were compared. The perioperative hemodynamics, sedation scores, meperidine consumption and side effects were followed up and registered. Results: The onset of shivering was significantly prolonged and the degree of shivering was less in pregabalin group compared to Control group. The duration of epidural shot was shorter in the control group in relation to the pregabalin treated patients. Regarding both onset and level of block, no significant changes were detected. The patients were more sedated with less meperidine consumption in the pregabalin group. The two groups were similar as regards the perioperative hemodynamics and occurrence of side effect. Conclusion: The premedication with pregabalin reduced onset and degree of shivering and prolonged the duration of single shot epidural block.

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Section: Discussionsupporting

confidence: 88%

“…Pharmacologically, opioids, alpha-2 agonists [6][7][8][9], ketamine [10] physostigmine [11], nefopam, tramadol [12], granisetron [13], doxapram, ketanserine [2] and dexamethasone [14] succeeded to reduce shivering. Also, amino acid infusion exerted a positive feedback in that field [15].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Oral Pregabalin on Epidural-Induced Shivering and Epidural Characteristics in Gynecological Surgeries, a Prospective Randomized Double-Blind Study

Menesy¹,

Adel²,

Badawy³

et al. 2018

Preprint

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“…Studies had shown that Nefopam could be used for the prevention of shivering after general anesthesia, spinal anesthesia or sedation for different minimally invasive interventions [58,59]. Bilotta [61].…”

Section: Other Clinical Propertiesmentioning

confidence: 99%

Nefopam and its Role in Modulating Acute and Chronic Pain

Ţigliş¹,

Neagu²,

Elfara³

et al. 2018

Rev. Chim.

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Pain is a very important issue to take into account during hospitalization. Nefopam, a centrally acting analgesic, has a relative safety pharmacological profile with few and well-tolerated side effects, being used to treat acute or chronic pain. It inhibits the central reuptake of serotonin, norepinephrine and dopamine and modulates the sodium and calcium channels having only few contraindications. Nefopam can be part of balanced analgesia along with others non-opioids agents in order to reduce the opioid consumption and their complications, to control postoperative pain and to reduce the risk of neuropathic pain appearance. In order to avoid its adverse reactions, a slow infusion is always recommended. Nefopam has its role in preventing the shivering appearance during neuraxial or general anesthesia, can modulate the emergence agitation after nasal and maxillofacial surgery and can inhibit the sever hiccup during mechanical ventilation. Some cases about fatal overdoses are reported in the literature.

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“…However, there is still no gold standard in this context. Nefopam is a promising drug because it is effective, but does not cause serious adverse effects [18][19][20][21]. In addition, it is also used to improve postoperative hypothermia in the field of plastic and aesthetic surgery.…”

Section: Aesthetic Plastic Surgerymentioning

confidence: 99%

Adverse Hemodynamic Effects of Nefopam in Patients Undergoing Plastic and Aesthetic Surgery: A Single-Center Retrospective Study

Choi

Kim

et al. 2018

Arch Aesthetic Plast Surg

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Background Nefopam is used to improve postoperative hypothermia in the field of plastic and aesthetic surgery. However, there is a paucity of data about its adverse hemodynamic effects and safety. We therefore assessed its adverse hemodynamic effects in patients undergoing plastic and aesthetic surgery. Methods We conducted a single-center retrospective study of 148 patients, in whom we measured hemodynamic parameters using sphygmomanometry (systolic blood pressure [SBP], diastolic blood pressure [DBP], arterial blood pressure [ABP], and heart rate [HR]). Moreover, we also assessed myocardial oxygen demand using the rate pressure product (RPP). Results The patients included 96 men and 52 women, with a mean age of 34.7±8.5 years. There were no significant differences in SBP, DBP, ABP, HR, or RPP before and after nefopam administration (P>0.05). However, a significant difference was found in the number of the patients with an HR of >100 beats per minute or with an RPP of >12 U before and after nefopam administration (P=0.001). Conclusions Surgeons should consider the possibility of tachycardia and increased blood pressure in the management of postoperative hypothermia in patients with cardiac arrhythmia, ischemic heart disease, or essential hypertension. Nonetheless, further prospective, large-scale, multi-center, randomized, controlled studies are warranted to confirm our results.

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Nefopam and tramadol for the prevention of shivering during neuraxial anesthesia

Cited by 10 publications

References 15 publications

The Effect of Oral Pregabalin on Epidural-Induced Shivering and Epidural Characteristics in Gynecological Surgeries, a Prospective Randomized Double-Blind Study

The Effect of Oral Pregabalin on Epidural-Induced Shivering and Epidural Characteristics in Gynecological Surgeries, a Prospective Randomized Double-Blind Study

Nefopam and its Role in Modulating Acute and Chronic Pain

Adverse Hemodynamic Effects of Nefopam in Patients Undergoing Plastic and Aesthetic Surgery: A Single-Center Retrospective Study

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