Single-dose intravenous nefopam on postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of prostate: a randomized, double-blind placebo-controlled trial

Charoenpol, Fa-ngam; Khampitak, Nutchanok; Aimnang, Charinee; Pachirat, Kachit; Sirithanaphol, Wichien; Rompsaithong, Ukrit; Kiatsopit, Pakorn; Lumbiganon, Supanut

doi:10.1007/s00540-022-03130-y

Cited by 3 publications

(9 citation statements)

References 22 publications

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“…After thoroughly examining the complete texts of these studies, we excluded 24 of them based on the reasons provided in Figure 1. Finally, the meta-analysis included five RCTs with 405 patients (202 in the nefopam group and 203 in the control group) (Cheon et al, 2018;Park et al, 2018;In et al, 2019;Gad et al, 2022;Charoenpol et al, 2023).…”

Section: Resultsmentioning

confidence: 99%

“…Some of these agents include ketamine, dexmedetomidine, antimuscarinics, gabapentin, tolterodine, and tramadol (Shi et al, 2021;Zhou et al, 2021;Li et al, 2022;Lu et al, 2022). Recently, scholars have suggested that nefopam may be effective in managing CRBD (Charoenpol et al, 2023;Ren et al, 2023). Nefopam, a centrally acting analgesic with anticholinergic properties, shows potential as an intervention for mitigating postoperative bladder discomfort (Evans et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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The systematic review and meta-analysis evaluated the efficacy and safety of nefopam for catheter-related bladder discomfort based on randomized controlled trials

Chi,

Wu,

Lou

et al. 2023

Front. Pharmacol.

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Background: Catheter-related bladder discomfort (CRBD) is a frequent occurrence following urinary catheterization during surgical procedures, as well as a commonly experienced bladder pain syndrome after surgery. There have been various studies on drugs and interventions to manage CRBD, but their comparative efficacy and safety are still a topic of debate. We conducted a meta-analysis to assess the efficacy and safety of nefopam for managing postoperative CRBD.Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to find randomized controlled trials (RCTs) on using nefopam in postoperative CRBD. The study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data analysis was performed using RevMan version 5.4.1.Results: Five RCTs with 405 patients were analyzed to evaluate the efficacy of nefopam on postoperative CRBD. Short-term and long-term periods were defined as within 6 h and longer than 12 h after surgery, respectively. The incidence and severity of CRBD were compared between the two groups during these time periods. The analysis proved that nefopam reduced the short-term incidence of postoperative CRBD (RR 0.36; 95% CI, 0.18–0.70; p = 0.003, I2 = 78%) and the long-term incidence (RR 0.49; 95% CI, 0.32–0.74; p = 0.0007, I2 = 0%) significantly. We compared the incidence of moderate-to-severe CRBD between groups based on the scaling system (none, mild, moderate, and severe). This was used to assess the severity of postoperative CRBD. The results showed that patients in the nefopam group had a significantly lower incidence of moderate-to-severe CRBD compared to those in the placebo group in the short-term (RR 0.19; 95% CI, 0.10–0.34; p < 0.00001; I2 = 0%). However, there were no significant differences between the two groups in the incidence of moderate-to-severe CRBD in the long-term (RR 0.61; 95% CI, 0.21–1.76; p = 0.36; I2 = 0%). There were no significant variations in the occurrence of adverse events between the nefopam and control groups, mainly including postoperative nausea and vomiting (PONV) (RR 1.14; 95% CI, 0.40–3.21; p = 0.81), and tachycardia (RR 0.25; 95% CI, 0.03–2.11, p = 0.20).Conclusion: The findings of this meta-analysis indicate that nefopam significantly reduced the incidence of short or long-term postoperative CRBD. Nefopam decreased the severity of postoperative CRBD, particularly significantly reducing the occurrence of moderate to severe CRBD in the short-term. Overall, patients have good tolerance and no apparent side effects.Systematic Review Registration: identifier PROSPERO (CRD42023475012)

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The systematic review and meta-analysis evaluated the efficacy and safety of nefopam for catheter-related bladder discomfort based on randomized controlled trials

Chi,

Wu,

Lou

et al. 2023

Front. Pharmacol.

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“…There is little evidence to support the use of nefopam in a palliative care setting although trials have been done showing that it reduces the need for postoperative analgesia if given preoperatively3 and intraoperatively 4. In a recent review5 of further surgical studies, nefopam reduced morphine consumption in 8 out 10 studies and also appeared to show synergy with non-steroidal anti-inflammatory drugs or paracetamol.…”

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confidence: 99%

Enteral nefopam for pain control at the end of life

Banting

2023

BMJ Support Palliat Care

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“…There are considerable advantages of performing TURP such as lower invasiveness, reduced mortality, and a shortened hospital stay compared to open surgical technique [ 2 ]. However, inserting an indwelling urinary catheter following TURP poses a significant challenge to the patients postoperatively [ 3 ].…”

mentioning

confidence: 99%

“…Increasingly, a bunch of perioperative management strategy for reducing the incidence and the severity of CRBD has been suggested. Several pharmacologic interventions with antimuscarinics, anticonvulsant, anesthetics, and several analgesics has been investigated to reduce CRBD [ 3 ].…”

mentioning

confidence: 99%

Catheter-Related Bladder Discomfort: The Unsolved Problem after Transurethral Resection of Prostate

Shin

Park

2023

World J Mens Health

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Single-dose intravenous nefopam on postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of prostate: a randomized, double-blind placebo-controlled trial

Cited by 3 publications

References 22 publications

The systematic review and meta-analysis evaluated the efficacy and safety of nefopam for catheter-related bladder discomfort based on randomized controlled trials

The systematic review and meta-analysis evaluated the efficacy and safety of nefopam for catheter-related bladder discomfort based on randomized controlled trials

Enteral nefopam for pain control at the end of life

Catheter-Related Bladder Discomfort: The Unsolved Problem after Transurethral Resection of Prostate

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