Median effective dose of nefopam to treat postoperative pain in patients who have undergone laparoscopic cholecystectomy

Heezoo Kim, Dong Kyu Lee, Mi Kyoung Lee, Mido Lee

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Objective: Nefopam is thought to reduce postoperative pain; however, the evidence is insufficient. The recommended dose is 20 mg, and the median effective dose (ED50) in the surgical setting reportedly ranges from 17 to 28 mg. However, nefopam frequently produces inadequate postoperative analgesia. We evaluated the ED50 of nefopam as a single agent in patients undergoing laparoscopic cholecystectomy. Methods: Twenty-nine patients were scheduled for laparoscopic cholecystectomy. Postoperative pain was evaluated using a numerical pain scale (NPS). When the NPS score was >3, patients were administered a predetermined dose of nefopam. The dose was calculated using the up-and-down allocation technique based on the previous response. The initial dose was 28 mg, with adjustment intervals of 5 mg. An effective response was defined as a decrease in the NPS score to <3 at 30 minutes after infusion. Results: The ED50 of nefopam was 62.1 mg (95% confidence interval, 52.9–72.9 mg). Eight patients reported pain upon injection, and three were excluded due to severe injection pain and phlebitis. Conclusions: The estimated ED50 was higher than the predetermined dose based on previous studies. We recommend that the dose of nefopam be chosen after careful consideration of individual variations and clinical settings.

Original languageEnglish
Pages (from-to)3684-3691
Number of pages8
JournalJournal of International Medical Research
Issue number9
Publication statusPublished - 2018 Sep 1


  • Nefopam
  • cholecystectomy
  • median effective dose
  • numerical pain scale
  • pain
  • postoperative

ASJC Scopus subject areas

  • Biochemistry
  • Cell Biology
  • Biochemistry, medical

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