Abstract Information 
Abstract ID
20260071
Category
Knee: ACL
Preferable Presentation
Both
Title
ANALGESIC EFFICACY OF INTRAVENOUS NEFOPAM AFTER ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A PROSPECTIVE, TRIPLE-BLIND, RANDOMIZED CONTROLLED TRIAL
Author
  • Full Name: WISET TANGPHROMPHAN
  • Affiliation/Institution: Department of Orthopedic Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • Country: Thailand

  • Full Name: ARTIT BOONROD
  • Affiliation/Institution: Department of Orthopedic Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • Country: Thailand

  • Full Name: AUMJIT WITTAYAPAIROJ
  • Affiliation/Institution: Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • Country: Thailand

  • Full Name: RUTTIYAPORN CHUMSRI
  • Affiliation/Institution: Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • Country: Thailand
Presenter
wiset tangphromphan
Abstract
Background: Arthroscopic anterior cruciate ligament reconstruction (ACLR) can cause
significant postoperative pain. Nefopam is a centrally acting non-opioid analgesic often used
in multimodal analgesia (MMA) regimens to improve recovery.

Objectives: The primary objective of this study was to evaluate the analgesic efficacy of
intravenous nefopam by measuring the Verbal Numerical Rating Scale (VNRS) pain score at
24 hours postoperatively. Secondary objectives included assessing morphine consumption,
postoperative adverse effects, and quality of recovery.

Study Design: This prospective, triple-blind, randomized controlled trial initially enrolled
52 patients undergoing ACLR, of whom 50 were included in the final analysis (25 per
group). Two patients were excluded due to spinal anesthesia failure requiring a change in
anesthesia method. The Nefopam group received intravenous nefopam 20 mg every 6 hours
for 24 hours, while the Control group received placebo. All patients received standardized
MMA including paracetamol, ketorolac, and patient-controlled analgesia morphine.

Results: At 24 hours postoperatively, the mean VNRS pain score at rest was lower in the
Nefopam group than in the Control group (1.08 ± 1.58 vs. 1.84 ± 1.80), although the
difference was not statistically significant (p = 0.1186). Cumulative 24-hour morphine
consumption was comparable between groups (9.96 ± 9.47 mg vs. 9.92 ± 6.31 mg; p =
0.9860). The incidence of adverse effects did not differ significantly between groups.

Conclusion: The addition of intravenous nefopam to a standard multimodal analgesic
regimen did not provide additional analgesic benefit beyond standard multimodal analgesia
following arthroscopic ACLR.