Postoperative pain and side effects after thyroidectomy: randomized double blind study comparing nefopam and ketorolac

ABSTRACT

BACKGROUND: Nefopam is a centrally acting, non-opioid analgesic drug used to reduce opioid consumption and so reduce the prevalence of postoperative nausea and vomiting (PONV). This study compared and assessed the effects of nefopam and ketorolac on postoperative pain and PONV after thyroid surgery. METHODS: Two hundred patients underwent total thyroidectomy with central compartment neck dissection in our hospital during a 5 month enrollment period. Group N and Group T was administered nefopam 20 mg and ketorolac 30 mg, respectively, during the last 30 minutes of surgery. Pain was measured using a 10-point numerical rating scale. Pain scores and PONV were assessed 30 min, 1, 6, and 24 h postoperatively. RESULTS: Pain scores and episodes of vomiting and shivering did not differ significantly between the two groups. Group N patients experienced fewer episodes of nausea at 30 min, 1 h and 6 h after the operation. CONCLUSIONS: Nefopam and ketorolac are similarly effective in reducing postoperative pain after thyroid surgery. Postoperative nausea was less in Group N patients within 6 h postoperatively, especially 1 h. Nefopam is favored for pain management after thyroidectomy.