The goal of this clinical trial is to determine whether continuous nefopam administration, as part of a multimodal analgesia strategy, reduces opioid consumption and improves patient satisfaction after pancreatoduodenectomy.

The main questions are:

Does nefopam administration reduce opioid consumption after pancreatoduodenectomy?

Does nefopam administration reduce postoperative pain levels after pancreatoduodenectomy?

Researchers will compare two other analgesic strategies, namely continuous lidocaine infusion and epidural analgesia, to assess whether they lead to better outcomes.

Participants will complete the QoR-15 questionnaire and report their pain levels at predefined time points before and after surgery.

Inclusion Criteria:

1. Patients scheduled for elective pancreatoduodenectomy surgery
2. Agreed to participate in the study

Exclusion Criteria:

1. Refusal to participate
2. Emergency surgery
3. Patients with neurological disorders or other muscular or psychiatric disorders that impede communication
4. Known allergic reactions to the used medication
5. Known hyperalgesia
6. Chronic opioid consumption
7. Patients that require reintervention in the first 48h postoperatively
8. Patients with pancreaticogastrostomy