• Mustafa Serinken, Cenker Eken, and Özgür Karcıoğlu.
• Department of Emergency Medicine, Pamukkale University School of Medicine, Denizli, Turkey
• Balkan Med J. 2018 Jul 24; 35 (4): 301-305.

BackgroundDysmenorrhea is one of the most common acute pain disorders among women of reproductive age.AimsTo compare the effects of IV paracetamol with dexketoprofen in patients presenting with primary dysmenorrhea to the emergency department.Study DesignRandomized controlled trial.MethodsPatients over 18 years old presenting with pelvic pain related to menstruation were eligible for the study. Study patients received 1 g paracetamol or 50 mg dexketoprofen in 100 mL normal saline with a 4-5 minute infusion via the intravenous route. Pain intensity was measured by a visual analog scale at 15 and 30 minutes. Patients were randomized and assigned to either of two study arms via sealed envelopes. Study drugs were identical in color, and thus both personnel and patients were blinded to the study drug. The dexketoprofen group comprised 49 patients, and the paracetamol group had 50 patients in the final analysis.ResultsThe mean age of the study subjects was 20.9±2.5 and the mean duration of the pain was 1.9±1.7 (median: 1, interquartile range: 1 to 2) hours. Both dexketoprofen (median change: 33, 95% CI: 24 to 38) and paracetamol (median change: 21, 95% CI: 12 to 32) effectively reduced the pain at 15 minutes, which was repeated at 30 minutes (median change: 63, 95% CI: 57 to 65 vs 55.5, 95% CI: 50 to 59, respectively). Pain improvement in the dexketoprofen group was better than in the paracetamol group at 15 (median difference: 8, 95% CI: 0 to 16, p=0.048) and 30 (median difference: 6, 95% CI: 1 to 12, p=0.028) minutes, which was statistically significant but not clinically significant.ConclusionDexketotoprofen has a better visual analogue scale score that is not clinically relevant compared to paracetamol.

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