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January 14, 2026Russian Journal of Anesthesiology and Reanimatology

Efficacy and safety of nefopam versus epidural analgesia for perioperative pain management in pancreaticoduodenectomy: a prospective randomized study

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Authors

YKYu.S. KorolevaP.A. Hertzen Moscow Oncology Research InstituteVKV. E. KhoronenkoPeoples' Friendship University of RussiaVTV.S. TrifanovP.A. Hertzen Moscow Oncology Research Institute

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Implication

Prospective trial shows nefopam reduces morphine use and postoperative pain in patients undergoing pancreaticoduodenectomy, suggesting benefits over epidural analgesia.

Key Points

  • This research aims to assess the efficacy and safety of nefopam compared to epidural analgesia for pain management during pancreaticoduodenectomy.
  • Randomized trial including 60 patients with biliopancreatoduodenal tumors undergoing (gastro)pancreatoduodenectomy.
  • Patients were assigned to nefopam (30) or epidural analgesia (30) groups.
  • Assessment of analgesia methods on postoperative pain, opioid requirements, and complications.
  • Pain scores were lower in the nefopam group on postoperative days 1 and 2.
  • Nefopam group required less morphine than the epidural analgesia group at multiple time points.
  • Independent predictors for pancreatic fistula included high BMI and intraoperative blood loss.

Cite This Study

Koroleva et al. (2025) studied this question.

synapsesocial.com/papers/6966e70113bf7a6f02bff2dbhttps://doi.org/10.17116/anaesthesiology202506176
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pancreatic fistula following pancreatoduodenectomy. Evaluation of different surgical approaches in the management of pancreatic stump. Literature review2015 · 77 citations
  2. 2Efficacy of postoperative epidural analgesia: a meta-analysis.2003 · 994 citations
  3. 3Intraoperative fluid administration is associated with perioperative outcomes in pancreaticoduodenectomy: A single center retrospective analysis2013 · 45 citations
  4. 4A meta analysis of efficacy and safety of nefopam for laparoscopic cholecystectomy pain management2025 · 2 citations
  5. 5Analgesic efficacy and safety of nefopam vs. propacetamol following hepatic resection*2001 · 147 citations