Department of Anesthesiology and Pain Medicine, Eunpyung St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.
Department of Surgery, Eunpyung St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.
Medicina (Kaunas). 2024 May 23;60(6):848. doi: 10.3390/medicina60060848.
: This study explored how nefopam, a non-opioid analgesic in a multimodal regimen, impacts postoperative pain, opioid use, and recovery quality in single-port robot-assisted laparoscopic cholecystectomy (RALC) patients with a parietal pain block, addressing challenges in postoperative pain management. : Forty patients scheduled for elective single-port RALC were enrolled and randomized to receive either nefopam or normal saline intravenously. Parietal pain relief was provided through a rectus sheath block (RSB). Postoperative pain was assessed using a numeric rating scale (NRS) in the right upper quadrant (RUQ) of the abdomen, at the umbilicus, and at the shoulder. Opioid consumption and recovery quality, measured using the QoR-15K questionnaire, were also recorded. : The 40 patients had a mean age of 48.3 years and an average body mass index (BMI) of 26.2 kg/m. There were no significant differences in the pre- or intraoperative variables between groups. Patients receiving nefopam reported significantly lower RUQ pain scores compared to the controls, while the umbilicus and shoulder pain scores were similar. Rescue fentanyl requirements were lower in the nefopam group in both the PACU and ward. The QoR-15K questionnaire scores for nausea and vomiting were better in the nefopam group, but the overall recovery quality scores were comparable between the groups. : Nefopam reduces RUQ pain and opioid use post-single-port RALC with a parietal pain block without markedly boosting RSB's effect on umbilicus or shoulder pain. It may also better manage postoperative nausea and vomiting, underscoring its role in analgesia strategies for this surgery.
: 本研究旨在探讨非阿片类镇痛药奈福泮在多模式方案中如何影响单孔机器人辅助腹腔镜胆囊切除术（RALC）患者的术后疼痛、阿片类药物使用和恢复质量，这些患者在接受腹直肌鞘阻滞（RSB）的同时还接受了壁痛阻滞。：共纳入 40 例择期行单孔 RALC 的患者，并随机分为奈福泮组或生理盐水组静脉注射。通过腹直肌鞘阻滞（RSB）提供壁痛缓解。术后疼痛采用数字评分量表（NRS）在右上腹部（RUQ）、脐部和肩部进行评估。还记录了阿片类药物的使用情况和使用 QoR-15K 问卷评估的恢复质量。：这 40 例患者的平均年龄为 48.3 岁，平均体重指数（BMI）为 26.2kg/m²。两组患者的术前和术中变量均无显著差异。与对照组相比，接受奈福泮的患者 RUQ 疼痛评分显著降低，而脐部和肩部疼痛评分相似。在 PACU 和病房中，奈福泮组的芬太尼解救需求较低。奈福泮组的恶心和呕吐 QoR-15K 评分较好，但两组的总体恢复质量评分相当。：奈福泮可降低接受壁痛阻滞的单孔 RALC 术后 RUQ 疼痛和阿片类药物使用，而不会明显增强 RSB 对脐部或肩部疼痛的作用。它还可能更好地管理术后恶心和呕吐，突出了其在这种手术的镇痛策略中的作用。
