• P Steffen, S Wiedemann, M Georgieff, J Hähnel, H Treiber, and W Seeling.
• Klinik für Anästhesiologie der Universität, Steinhövelstraße 9, D-89075, Ulm.
• Schmerz. 1994 Dec 1;8(4):235-42.

AbstractIn a double-blind, randomized, placebo-controlled study, 112 patients scheduled for knee-joint arthrotomies or minor orthopaedic operations received 75 mg diclofenac, 600 mg apazone, the combination of 75 mg diclofenac and 600 mg apazone, or placebo (50 ml NaCl 0.9%) as a single i.v. dose immediately after operation. Postoperative pain intensity was measured by a numeric rating scale. All patients were allowed to self-administer piritramide from a PCA (patient-controlled analgesia) pump (Prominjekt, Pharmacia, Sweden) in 2-mg boluses every 5 min during the first 6 h and subsequently every 15 minfor another 18 h after surgery. The patients receiving diclofenac, apazone, or the combination of diclofenac and apazone required a significantly lower cumulated dose of piritramide during the first 24 h after operation than did placebo-treated subjects (38 mg vs 39 mg vs 27 mg vs 67 mg;P<0.05), but there were no significant differences among the former three groups of patients. The incidence of typical side effects of opioids and antipyretic anti-inflammatory analgesics (nausea, vomiting, stomach ache, headache, vertigo) was low, and they were easily controlled in all cases. Postoperative combined application of the nonsteroidal anti-inflammatory analgesics diclofenac and apazone results in a significantly lower opioid requirement (about 60%) after minor orthopaedic surgery. The opioid-sparing effect appears to be superior to that of diclofenac (44%) or apazone (42%) alone, but this was not statistically significant.

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