Objective — to evaluate the efficiency and safety of using the centrally-acting nonopioid analgesic nefopam as part of multimodal anesthesia and postoperative analgesia in abdominal cancer surgical patients. Subjects and methods. A clinical trial was conducted in 317 patients (mean age 56.7±10.2 years) who had undergone radical abdominal cancer surgery under combined systemic and epidural anesthesia. The efficiency and safety of using nefopam as a component of patient anesthesiological protection during and after surgery were analyzed. Results. During the use of nefopam, 25% of the patients needed no additional administration of an opioid analgesic, suggesting the high analgesic capacity of the drug. Within the first 2 days, 75% of cases required the administration of trimeperidine in a dose of 20 to 40 mg. Within the first 24 hours, the mean opioid dose was 29.3±11.2 mg. By day 2, the opioid dose was substantially decreased and amounted to 18.9±12.4 mg. On postoperative day 3, only 80 (31%) of 250 patients needed the opioid to be additionally administered. On day 4, none of the examinees reported their need for the analgesic narcotic. Conclusion. nefopam showed a high efficacy in the prevention and treatment of postoperative pain syndrome, acute opioid tolerance and muscle trembling. The use of nefopam as a component of postoperative analgesia could considerably reduce the need for the opioid analgesic, achieve adequate anesthesia, and prevent central nervous system and respiratory depression. No adverse reactions of the drug in the used dose were found in any case.