Usefulness of nefopam in treating pain of severe uncomplicated renal colics in adults admitted to emergency units: a randomised double-blind controlled trial. The ‘INCoNU’ study

Moustafa, Farès; Liotier, Jérôme; Mathevon, Thierry; Pic, D.; Perrier, Christophe; Schmidt, Jeannot

doi:10.1136/emermed-2011-200753

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…Such reactions have been reported previously, although rarely. 26 Because the present study was the first to include administration of a large single dose of nefopam, the pain on injection and phlebitis may have been related to the quantity of nefopam administered. Further investigation is required to determine the occurrence of pain on injection and phlebitis according to the administration dose of nefopam.…”

Section: Discussionmentioning

confidence: 90%

Median effective dose of nefopam to treat postoperative pain in patients who have undergone laparoscopic cholecystectomy

Kim

Lee

et al. 2018

J Int Med Res

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ObjectiveNefopam is thought to reduce postoperative pain; however, the evidence is insufficient. The recommended dose is 20 mg, and the median effective dose (ED50) in the surgical setting reportedly ranges from 17 to 28 mg. However, nefopam frequently produces inadequate postoperative analgesia. We evaluated the ED50 of nefopam as a single agent in patients undergoing laparoscopic cholecystectomy.MethodsTwenty-nine patients were scheduled for laparoscopic cholecystectomy. Postoperative pain was evaluated using a numerical pain scale (NPS). When the NPS score was >3, patients were administered a predetermined dose of nefopam. The dose was calculated using the up-and-down allocation technique based on the previous response. The initial dose was 28 mg, with adjustment intervals of 5 mg. An effective response was defined as a decrease in the NPS score to <3 at 30 minutes after infusion.ResultsThe ED50 of nefopam was 62.1 mg (95% confidence interval, 52.9–72.9 mg). Eight patients reported pain upon injection, and three were excluded due to severe injection pain and phlebitis.ConclusionsThe estimated ED50 was higher than the predetermined dose based on previous studies. We recommend that the dose of nefopam be chosen after careful consideration of individual variations and clinical settings.

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Section: Discussionmentioning

confidence: 90%

Median effective dose of nefopam to treat postoperative pain in patients who have undergone laparoscopic cholecystectomy

Kim

Lee

et al. 2018

J Int Med Res

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“…The present study is aimed to overcome such troublesome side effects by focusing attention on the use of nefopam hydrochloride as an alternative to opioid and steroidal analgesics because of its superior advantages: (i) it is a central analgesic with non-opiate action; (ii) it is a non-steroidal analgesic; (iii) it is effective in postcardiac operative analgesia; (iv) it is superior to aspirin; (v) it causes fewer side effects; (vi) it shows incompetence of respiratory depression compared with morphine and oxycodone; and (vii) there is a lower probability of common death from overdose compared with opioid analgesic drugs . Interestingly, nefopam hydrochloride was developed in the early 1960s, and its consumption has been limited to European countries, where it is widely used for the prevention of postoperative shivering, severe hiccups, post-trauma and postoperative pain, dental pain, and renal colic pain . At the same time, a practical commercial process with good yield and purity is found to be essential for its quick adoptability throughout the world, as its availability is now limited to France, the U.K., and a few other European countries.…”

Section: Introductionmentioning

confidence: 99%

“…15 Interestingly, nefopam hydrochloride 16 was developed in the early 1960s, and its consumption has been limited to European countries, where it is widely used for the prevention of postoperative shivering, 17 severe hiccups, 18 post-trauma and postoperative pain, 19 dental pain, 20 and renal colic pain. 21 At the same time, a practical commercial process with good yield and purity is found to be essential for its quick adoptability throughout the world, as its availability is now limited to France, the U.K., 22 and a few other European countries.…”

Section: ■ Introductionmentioning

confidence: 99%

Old is Gold? Nefopam Hydrochloride, a Non-opioid and Non-steroidal Analgesic Drug and Its Practical One-Pot Synthesis in a Single Solvent for Large-Scale Production

Mohan

Krishnaiah

Babu

et al. 2017

Org. Process Res. Dev.

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Nefopam hydrochloride is extensively used in most of the European countries until today as an analgesic because of its non-opiate (non-narcotic) and non-steroidal action with fewer side effects compared with opioid and other analgesics, which cause more troublesome side effects. A multikilogram synthesis of nefopam hydrochloride has been achieved in one pot using a single solvent (toluene). A ≥99.9% purity of the active pharmaceutical ingredient (API) was achieved in excellent overall yield (≥79%). The one-pot, five-step synthetic process involves formation of an acid chloride (3) from benzoylbenzoic acid (2) followed by amidation (4), reduction (5), cyclization (6), and formation of the hydrochloride salt (1). The major advantages include (i) use of a single solvent, (ii) >90% conversion in each step, (iii) a cost-effective and operationally friendly process, (iv) averting the formation of genotoxic impurities, and (v) improved overall yield (≥79%) provided by the one-pot operation. For the first time, we report the characterization data of API 1, intermediates 3, 4, and 5, and also a possible impurity (5a).

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Endogenous opiates and behavior: 2013

Bodnar

2014

Peptides

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This paper is the thirty-sixth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2013 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia; stress and social status; tolerance and dependence; learning and memory; eating and drinking; alcohol and drugs of abuse; sexual activity and hormones, pregnancy, development and endocrinology; mental illness and mood; seizures and neurologic disorders; electrical-related activity and neurophysiology; general activity and locomotion; gastrointestinal, renal and hepatic functions; cardiovascular responses; respiration and thermoregulation; and immunological responses.

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Usefulness of nefopam in treating pain of severe uncomplicated renal colics in adults admitted to emergency units: a randomised double-blind controlled trial. The ‘INCoNU’ study

Abstract: http://ClinicalTrials.gov ID number NCT00639574.

Cited by 5 publications

References 23 publications

Median effective dose of nefopam to treat postoperative pain in patients who have undergone laparoscopic cholecystectomy

Median effective dose of nefopam to treat postoperative pain in patients who have undergone laparoscopic cholecystectomy

Old is Gold? Nefopam Hydrochloride, a Non-opioid and Non-steroidal Analgesic Drug and Its Practical One-Pot Synthesis in a Single Solvent for Large-Scale Production

Endogenous opiates and behavior: 2013

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