Comparison of the Analgesic Dose‐Effect Relationships of Nefopam and Oxycodone in Postoperative Pain

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Abstract
The analgesic dose-effect relationship of nefopam [NP] was compared in a double-blind randomized trial with that of oxycodone [OC] in immediate postoperative pain. NP 15 mg or OC 4 mg was given every 10 min i.v. (maximum 6 .times.) to patients in pain after upper abdominal surgery until their wound pain (scored 0-3) disappeared. The mean pain intensity (PI), initially 2.2 in both groups, decreased by .apprx. the same extent for up to 2 doses in both groups (to 1.5 after NP 30 mg and to 1.1 after OC 8 mg). Thereafter PI was significantly less in the OC group and diminished almost linearily to 0.1 after the 6th dose (24 mg). In the NP group, the PI score fell to 1.1 after the 4th dose (60 mg). This seemed to be the ceiling effect since additional doses up to 90 mg did not result in greater pain relief. In the OC group, only 2 patients (12%) needed maximal dosage (6 .times. 4 mg), one of them requiring 32 mg of OC. In the NP group, 12 patients (75%) needed further pain relief after the maximal dosage (6 .times. 15 mg). In these patients, OC (maximally 16 mg) gave satisfactory analgesia. Drowsiness and a decrease in the respiratory rate were the principal side-effects of OC, whereas tachycardia, restlessness sweating and nausea were more frequent after NP.

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