Nefopam and propoxyphene in episiotomy pain

Abstract

To evaluate relative efficacy, safety and time course of analgesia, nefopam [N] (45 and 90 mg), a new centrally acting nonnarcotic analgesic, was compared with proproxyphene [PP] (65 mg) and placebo in a single oral dose, parallel, stratified, randomized, double-blind trial with 100 hospitalized postpartum women with medium or severe episiotomy pain. Using subjective reports as indices of response, patients rated pain intensity and side effects as periodic interviews for 6 h. After 45 and 90 mg NF, 21 of 25 and 20 of 25 patients reported more than 50% reduction of pain, whereas after 65 mg PP 18 of 25 and after placebo 11 of 25 reported reduction in pain. Relative efficacy, based on summed pain intensity differences, showed measurable but modest dose-dependent analgesia with NF, suggesting that the effectiveness of 65 mg PP lay between 45 mg NF and placebo. Side effects included mild dizziness and hypothermia after NF and mild elevation of diastolic arterial pressure after NF and PP. Apparently 45 and 90 mg doses of NF induced more analgesia than 65 mg PP in the relief of episiotomy pain.