COMPARISION OF POST OPERATIVE ANALGESIC EFFECT OF NEFOPAM HYDROCHLORIDE AND DICLOFENAC SODIUM IN LAPAROSCOPIC SURGERY
Authors: V Yathish , D R Rakesh , Aparna A. , MR Bharath 
Published: February 2024

Introduction: Pain is dened as “An unpleasant sensory and emotional experience associated with actual or potential
tissue damage, or described in terms of such damage.” Nefopam is a potent non- narcotic centrally acting analgesic with
both supraspinal and spinal sites of action. Nefopam is chemically distinct and pharmacologically unrelated to any presently known analgesic.
Diclofenac sodium is a nonsteroidal anti-inammatory drug (NSAID) used for management of mild to moderate pain and management of
moderate to severe pain alone or in combination with opioid analgesics. NSAIDs work by inhibiting the activity of cyclooxygenase enzymes
(COX-1 and/or COX-2). These enzymes are involved in the synthesis of key biological mediators, namely prostaglandins which are involved in
inammation, and thromboxane's which are involved in blood clotting. Materials And Methods: All cases of Laparoscopic surgeries of ASA
grade I, II and III Patients. Pre anesthetic evaluation will be done and the techniques will be explained to patients including benets and
complications of each and written consent will be taken for the same. So, considering dropouts, total 60 patients will be enrolled, 30 patients in
each group allotted as per sample size selection of cases on Randomized Controlled trial (RCT) by computer generating numbers. Patient with
odd number will be assigned to group N and even number will be assigned to group D. Two investigators will participate in the study, rst
investigator will prepare the drugs and second investigator will be responsible for monitoring and data collection and will be blinded to the study.
Results: In study shows Post Operative Systolic Blood Pressure. There was no signicant difference in systolic blood pressure among the group
at 0 min (p>0.05). The SBP decreased in Group N compared to Group D at rest of the intervals in Post operative period and statistically
signicant. In this study shows Post Operative Diastolic Blood Pressure. There was no signicant difference in systolic blood pressure among
th st nd th the group at 0, 10, 15min and 6 hour interval(p>0.05). The DBP decreased in Group N at 30min,1 , 2 ,4 hour interval as compared to Group D
and statistically signicant (p>0.05). In our study shows Ramsay Sedation Score. There was signicant difference in Ramsay Sedation Score
among the group at 0 min interval(p>0.05). There was no signicant difference in Ramsay Sedation Score among the group in rest of the
intervals. VAS Scores are comparatively less in Group N at 0 , 10 , 15 min compared to Group D and statistically signicant. Mean VAS score at
th 6 hour in Group N is 2.85 hour and in Group D is 2.84 hour. Rescue analgesia is given when VAS score is >4. Conclusion: Nefopam improves
the quality and duration of postoperative analgesia with better patient satisfaction in compare to diclofenac sodium. Nefopam is a centrally
acting, non-opiate and non-steroidal analgesic. It is structurally not related to other analgesic drugs, has unique mechanism of action, acts by
modulation of descending pain pathway by triple neurotransmitter receptor inhibition, effective for postoperative pain. It is well tolerated,
without habituation or dependency and devoid of Opioids and NSAIDs side effects