Effect of Nefopam on Remifentanil Induced Postoperative Hyperalgesia
Overview
- Phase
- Not Applicable
- Intervention
- low dose remifentanil
- Conditions
- Patients Undergoing Laparoscopic Gastrectomy
- Sponsor
- Yonsei University
- Enrollment
- 25
- Locations
- 1
- Primary Endpoint
- Hyperalgesic extent around surgical incision
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
Opioids has been reported to cause hyperalgesia. Opioid induced hyperalgesia (OIH) is defined as paradoxically lowering the threshold of pain after the exposure of opioid. Remifentanil is a short acting opioid that is commonly used during anesthesia and surgery. However, OIH was reported to occur after surgery when large amount of remifentanil was administered. On the other hand, nefopam is a centrally acting, non-opioid analgesic. Nefopam has been reported to have analgesic and anti-hyperalgesic effect.
The investigators hypothesized that nefopam administration could prevent OIH or reduce the severity of OIH. Therefore, the objective of the study is to find out the effect of nefopam on remifentanil induced hyperalgesia in patients undergoing laparoscopic abdominal surgery.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients undergoing laparoscopic gastrectomy
- •American Society of Anesthesiologists physical status I or II
- •aged from 20 to 65 years
Exclusion Criteria
- •Past history of chronic pain
- •Drug or alcohol abuse
- •Psychotic disorder
- •Taking analgesics, anti-epileptics, and anti-depressants.
- •Taking opioids within 24 hrs
- •Renal disease
- •Neuromuscular disease.
- •Moderate to severe cardiovascular disease
- •Pregnant or breast-feeding
Arms & Interventions
group L
receives 100 ml of 0.9% saline immediately after anesthesia induction and 0.05µg/kg/min of remifentanil during anesthesia.
Intervention: low dose remifentanil
group H
100 ml of 0.9% saline immediately after anesthesia induction and 0.3 µg/kg/min of remifentanil during anesthesia.
Intervention: high dose remifentanil
group N
20mg of nefopam mixed in 100 ml of 0.9% saline immediately after anesthesia induction and 0.3 µg/kg/min of remifentanil during anesthesia.
Intervention: Nefopam
Outcomes
Primary Outcomes
Hyperalgesic extent around surgical incision
Time Frame: Postoperative 24 hr and 48 hr
The distance from the surgical incision to a point where patient does not feel pain when he gets stimuli with von Frey filament No.16 (122g/mm2).