{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:04:18Z","timestamp":1789538658378,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine Siriraj Hospital, Mahidol University","doi-asserted-by":"publisher","award":["R016432020"],"award-info":[{"award-number":["R016432020"]}],"id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Uvulopalatopharyngoplasty (UPPP) is a surgical treatment for obstructive sleep apnea that often results in significant postoperative pain. Given the risks associated with opioid use in patients with obstructive sleep apnea, multimodal analgesia is preferred. This study evaluated whether nefopam, a non-opioid analgesic, without respiratory depressive effects, could reduce morphine consumption and improve postoperative recovery in patients undergoing UPPP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, exploratory, randomized, triple-blinded trial enrolled patients scheduled for elective UPPP. Participants were randomly assigned to receive either nefopam or a placebo (normal saline). The nefopam group received a 20\u00a0mg intravenous loading dose over 1\u00a0h, followed by a continuous infusion of 80\u00a0mg over 24\u00a0h. Both groups received standard multimodal analgesia. The primary outcome was total morphine consumption within 24\u00a0h postoperatively. The secondary outcomes were postoperative pain scores, time to first oral intake, patient satisfaction, quality-of-life scores, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-one patients were analyzed (nefopam: 26, control: 25). The median 24-hour morphine consumption was 7\u00a0mg in the nefopam group and 5\u00a0mg in the control group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.56). No significant differences were found between groups in postoperative pain scores, time to first oral intake, patient satisfaction, or quality-of-life scores. Adverse event rates were similar, although tachycardia (11.5%) and sweating (3.8%) were observed only in the nefopam group. Subgroup analysis in UPPP alone and extended UPPP surgery likewise revealed no significant differences between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nefopam is not recommended for pain management following UPPP as it did not significantly reduce morphine consumption or improve pain-related outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-026-10472-w","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:28:10Z","timestamp":1789536490000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A randomized trial of nefopam for postoperative pain management in obstructive sleep apnea patients undergoing uvulopalatopharyngoplasty"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2594-2328","authenticated-orcid":false,"given":"Saowapark","family":"Chumpathong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-5974","authenticated-orcid":false,"given":"Peerachatra","family":"Mangmeesri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriwimon","family":"Panyamee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4029-6657","authenticated-orcid":false,"given":"Wish","family":"Banhiran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5917-2470","authenticated-orcid":false,"given":"Maythad","family":"Uataya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"10472_CR1","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1177\/2040622315590318","volume":"6","author":"L Spicuzza","year":"2015","unstructured":"Spicuzza L, Caruso D, Di Maria G (2015) Obstructive sleep apnoea syndrome and its management. 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This randomized clinical trial was registered in the Thai Clinical Trials Registry (TCTR20210203007).","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflict of interest.","order":3,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}