The effects of nefopam hydrochloride and tramadol hydrochloride on postoperative pain in patients undergoing long bone fracture fixations: A randomised triple blinded study

Abstract

Orthopaedic surgery has one of the most painful post-operative periods. Pain management is an important consideration in Orthopaedic department. The purpose of this study was to assess the effect of Nefopam hydrochloride and Tramadol hydrochloride in postoperative analgesia in patients undergoing long bone fracture fixations.Triple blindedRandomization and allocation to study groups were carried out by odd and even number method. The study was conducted in tertiary care center from May 2019 till March 2020.184 patients who underwent Orthopaedic surgery were included in this randomized study. 92 patients were placed each in group-A and B. Patients in group-A received Tramadol hydrochloride and in group-B received Nefopam hydrochloride. The primary outcome measures were pain intensity assessed by using a Visual Analogue Scale (VAS) Score, Verbal Rating Scale (VRS) score whereas the secondary outcome measures included side effects related to the drugs and number of patients who required rescue analgesia. Unpaired t-test and Chi-square test was used to carry out all the data analysis. The pain intensity assessed on VAS score was significantly better for Tramadol group compared to Nefopam group at all time periods except at 15 minutes and a significant difference was present in verbal rating scale score between the groups only at 24 hours. Side effect profile and requirement of rescue analgesia were more in Nefopam hydrochloride group.Tramadol hydrochloride was more effective in providing post-operative pain relief in patients compared to Nefopam hydrochloride.