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EFFECTIVENESS OF NEFOPAM IN PREVENTING POSTANESTHETIC SHIVERING AFTER LAPAROSCOPIC ABDOMINAL SURGERY
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Abstract
Objective: To assess the effectiveness of nefopam in preventing postoperative shivering following general anesthesia in patients undergoing laparoscopic abdominal surgery. Methods: A prospective descriptive study was conducted on 64 patients (≥16 years, ASA I–III) undergoing laparoscopic abdominal surgery at 103 Military Hospital from December 2024 to May 2025. Patients were divided into two groups: Group NK (n = 31) received 20 mg nefopam intravenously plus 30 mg ketorolac intramuscularly; Group K (n = 33) received ketorolac only. Postoperative shivering was evaluated using the Crossley–Mahajan scale. Hemodynamic parameters and adverse effects were recorded. Results: The incidence of postoperative shivering was significantly lower in Group NK (9.7%) than in Group K (42.4%; p = 0.004). Shivering in Group NK was mostly mild (grades 1–2), with no cases of grade 3, whereas 71.4% of shivering in Group K was grade 3 (p = 0.051). The duration of shivering was shorter in Group NK (10.5 ± 4.7 vs. 22.3 ± 12.6 minutes; p = 0.023). No significant differences in adverse effects were observed between groups. Conclusion: Intravenous nefopam combined with ketorolac significantly reduces the incidence, severity, and duration of postoperative shivering, making it a safe and effective prophylactic strategy.
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Keywords
nefopam, postoperative shivering, general anesthesia, laparoscopy.
References
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