Proceedings of the Western Pharmacology Society
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Proc. West. Pharmacol. Soc. · Jan 2010
Randomized Controlled Trial Comparative StudyEffectiveness of diclofenac, ketorolac and etoricoxib in the treatment of acute pain from ankle fracture.
Tissue degeneration, infection, inflammation, cancer, trauma, surgery and limb fractures all produce pain. Each of these physiological abnormalities requires a therapeutic approach different from the last. In acute pain, caused by fracture, several classes of analgesics have been utilized. ⋯ All treatments showed a similar profile in pain reduction. Etoricoxib, diclofenac and ketorolac twice daily are a rapid and effective treatment for acute pain. All the regimens were well tolerated in this study.
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Proc. West. Pharmacol. Soc. · Jan 2010
Randomized Controlled Trial Comparative StudyPercutaneous microdiscectomy versus epidural injection for management of chronic spinal pain.
In this study we present the efficacy of aspiration of disc material employing the Stryker Disc Dekompressor during percutaneous microdiscectomy for the treatment of chronic spinal and radicular pain due to contained lumber disc herniation and compare the short-term outcome in such patients with those who received lumber epidural injection. A total of 50 patients with chronic lumber discogenic pain and radiculopathy were enrolled in this study and were randomized into two groups. Group 1 (n=26) underwent first time, single-level lumber discectomy at either L3-4, L4-5, or L5-S1 using the Stryker Disc Dekompressor for aspiration of disc material and Group 2 (n=24) received epidural steroid/local anesthetic injection. ⋯ We conclud that when standardized patient selection criteria are used, the disc DeKompressor is a safe and more effective treatment for radicular pain of discogenic origin than epidural injection with steroid/local anesthetic. Back pain of discogenic origin was more effectively treated with the epidural steroid/local anesthetic injection. Treatment of patients with radicular pain associated with contained disc herniation using the Dekompressor can be a safe and more effective procedure.
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Proc. West. Pharmacol. Soc. · Jan 2009
Randomized Controlled TrialEfficacy of postoperative continuous wound infiltration with local anesthetic after major abdominal surgery.
The aim of this study was to evaluate the analgesic efficacy, safety, opioid sparing effects and improvement of respiratory function when using 0.2% ropivacaine continuous wound infiltration after major intra-abdominal surgery. Forty patients undergoing major intra-abdominal surgery requiring a midline incision of > or = 20 cm were enrolled into this IRB-approved, randomized, prospective controlled study. Group 1: 20 patients, parenteral analgesia (control group). ⋯ The patient vital capacities were insignificantly higher in group II. We conclude that after major abdominal surgery, infiltration and continuous wound instillation with 0.2% ropivacaine decreases postoperative pain, opioid requirements and oral analgesia. Early patient rehabilitation, hastening convalescence, and preventing respiratory complications are expected outcomes of this approach.
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Proc. West. Pharmacol. Soc. · Jan 2008
Randomized Controlled TrialA pilot study of the effect of diclofenac with B vitamins for the treatment of acute pain following lower-limb fracture and surgery.
The aim of this pilot study was to compare the efficacy and tolerability of the non-steroidal anti-inflammatory drug (NSAID), diclofenac (2-(2,6-dichloranilino) phenylacetic acid), for treatment of acute pain originated by lower-limb fracture and surgery, with that of diclofenac plus B vitamins. This clinical trial was single-center, prospective randomized and double-blinded. After giving informed consent, patients with lower-limb closed fractures rated their pain on a 10-cm visual analog scale (VAS). ⋯ The subjects' assessments of limb pain on the visual analog scale showed a significant reduction from baseline values regardless of the treatment group when surveyed at 12, 24, 36 and 48 hr post operation. All treatments showed a similar profile in pain reduction. There were reports of pain in the administration site, but in general, all the regimens were well tolerated.
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Proc. West. Pharmacol. Soc. · Jan 2005
Randomized Controlled TrialAnalgesic efficacy of tramadol by route of administration in a clinical model of pain.
The objective of this study was to evaluate the analgesic efficacy produced by tramadol given by two different routes of administration in patients experiencing pain after removal of an impacted mandibular third molar under local anesthesia. A double-blind, randomized, placebo-controlled clinical trial was conducted. Patients were assigned into four groups of treatment, twelve subjects per group: Group A, tramadol 50 mg IM one hr before surgery; group B, tramadol 50 mg into the surgical site; group C, tramadol by both routes of administration, 50 mg IM one hr before surgery plus 50 mg into the surgical site; and group D, control. ⋯ However, only in the route combination group was a significant reduction in the requirement of acetaminophen observed. Nine patients requiring additional medication were treated with ketorolac 30 mg injected intramuscularly; 2 in the systemic group, 2 in the local group, 4 in the control group and only 1 in the combination group. Adverse events were minimal and similar in all groups.