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Canadian Journal of Anesthesia, Vol 26, 296-304, Copyright © 1979 by Canadian Anesthesiologists' Society

Comparison of Nefopam Hydrochloride and Propoxyphene Hydrochloride in the Treatment of Postoperative Pain

D. TROP M.D., F.R.C.P.(C)1, L. KENNY R.N.1, and B. R. GRAD Ph.D.1

1 Department of Anaesthesia, Montreal Neurological Institute, 3801 University Street, Montreal, Quebec, H3A 2B4

To compare the analgesic activity of nefopam HCl with d-propoxyphene HCl, 85 male and 40 female in-patients, between 18 and 73 years of age, suffering moderate to severe postoperative pain one to three days after operation, were assigned randomly to one of five treatment groups of 25 patients each. Two groups were given nefopam HCl, one 60 mg and the other 90 mg, while two other groups received d-propoxyphene HCl, 65 mg and 130 mg respectively. The fifth group received a placebo.

The efficacy of the drugs was assessed double blind by analyzing the pain intensity, pain intensity differences, weighted sum of pain intensity differences, pain relief and weighted total pain relief scores based on a 4-point pain intensity and 5-point pain relief scale determined 0.5, 1, 2, 3, 4, 5, and 6 hours after the administration of the medication.

The pain relief and weighted sum of pain intensity difference values were most effective in detecting differences between the active drugs and placebo. Pain intensity differences and weighted total pain relief scores were less useful in this respect. The efficacy of d-propoxyphene 130 mg and nefopam HCl 60 mg were not significantly different from one another, while each was significantly more effective than placebo. Nefopam HCl 90 mg and d-propoxyphene 65 mg and placebo were not significantly different.

Light-headedness, grogginess and drowsiness were reported more frequently for propoxyphene than for placebo; sweating, tachycardia, sleepiness and tiredness were observed more often with nefopam than with placebo. Nefopam caused a greater incidence of sweating than propoxyphene, while the latter was responsible for the more frequent occurrence of a dry mouth and light-headedness than the former.

According to this study, nefopam HCl 60 mg was as effective as d-propoxyphene HCl 130 mg in alleviating moderate to severe postoperative pain one to three days after operation.






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Copyright © 1979 by the Canadian Anesthesiologists' Society.