Comparative evaluation of efficacy and safety of etodolac and diclofenac sodium injection in patients with postoperative orthopedic pain

Background: Post-operative pain management is an important consideration in the orthopedic department. The purpose of this study was to compare the analgesic efficacy of tramadol with diclofenac sodium in patients with postoperative orthopedic pain.Methods: A hospital based, prospective, observational study was undertaken in Department of Orthopedics for a period of one year. A group of 60 patients having post-operative pain intensity assessed as 6cm or more on a 10cm visual analogue scale (VAS) were assigned to receive either tramadol thrice a day (n=30) or diclofenac sodium thrice a day (n=30). Both drugs were administered parenterally for initial 24hr, then orally for next 96 hr. The primary efficacy outcome measures were pain intensity difference assessed at 2hr, 4hr, 8hr, 16hr, 24hr, 32hr, 40hr, 48hr, 56hr, 64hr, 72hr, 80hr, 96hr, 104hr, 112hr and 120hr using a VAS and sum of pain intensity differences assessed at 8hr, 24hr, 48hr, 72hr, 96hr and 120hr whereas secondary efficacy measures included maximum fall in pain intensity, number of patients who required rescue medication and their quality of sleep in the night.Results: Mean pain intensity differences assessed on 10cm VAS were significantly better for tramadol group compared to diclofenac group at all the time points except 88 hr. Sum of pain intensity differences over 8hr, 24hr, 48hr, 72hr, 96hr and 120 hr for the tramadol group was significantly superior than diclofenac group. Maximum fall in pain intensity score was also significantly superior in the tramadol group as compared to the diclofenac group. However, no patients required rescue medication in either of the groups. Patient’s quality of sleep improved with both drugs but tramadol produced significantly better quality of sleep every night than did diclofenac. Both the study medications produced effective analgesia and were well tolerated with no incidence of serious adverse effects throughout the study.Conclusions: Tramadol has a more pronounced analgesic effect than diclofenac. Thus, tramadol can be considered as an effective alternative to traditional NSAIDs in the treatment of post-operative pain.

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“…3 Therefore, injectable forms of the tramadol and diclofenac were used in this study for the initial 24hours followed by oral form of the drugs.…”

Section: 21mentioning

confidence: 99%

“…3 Approaches to pain relief may differ depending on the type of surgery, the patient, and the drugs administered. 2 The best postoperative pain regimen is one that offers broad analgesic coverage, is easy to administer, and is safe.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of analgesic efficacy of tramadol and diclofenac-sodium in post-operative orthopedic patients

Paudel

Deka

Gupta

et al. 2017

Int J Basic Clin Pharmacol

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“…Akbulut N et al reported that diclofenac sodium was a better analgesic compared to etodolac, although without statistical significance [26]. Diclofenac sodium and etodolac have been proven effective as an analgesic for pain associated with oral surgery, orthopedic disorders, and rheumatoid arthritis [34][35][36]. Silva et al reported that etodolac is a better analgesic after surgical extraction of third molars compared to ibuprofen [19].…”

Section: Discussionmentioning

confidence: 99%

“…It has shown better gastrointestinal tolerability to diclofenac and other NSAIDs [34,38] and has also been proven an effective alternative to diclofenac sodium in orthopedic pain [35]. An etodolac dose of 400 mg has been shown to have better analgesic effects compared to other doses postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of safety and analgesic efficacy of diclofenac sodium with etodolac after surgical extraction of third molars: a randomized, double-blind, double-dummy, parallel-group study

Vaghela¹,

Shah

Patel

et al. 2020

J Dent Anesth Pain Med

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Background: Surgical extraction of third molars is associated with postoperative pain and swelling at the extraction site. Pain is commonly managed using non-steroidal anti-inflammatory drugs (NSAIDs). Postoperative pain is usually moderate to severe in the first 12 h postoperatively and lasts for 3-5 days. However, with NSAIDs, these symptoms usually subside within 24 h. Diclofenac sodium and etodolac are NSAIDs, more selectively cyclooxygenase-2 inhibitors, with good analgesic efficacies. Methods: We compared the safety and analgesic efficacy of diclofenac sodium with etodolac peroral after surgical extraction of third molars in a double-blind, double-dummy, parallel-group study. The subjective pain improvement and pain relief after 2, 6, 24, 48, and 72 h using the visual analogue scale were measured as the study outcome. Results: Etodolac was equivalent to diclofenac sodium in pain alleviation at all postoperative time periods. No significant differences were found between diclofenac sodium and etodolac groups (P > 0.05). Both study medications were well tolerated and safe with mild adverse effects in only a few participants. Conclusion: Diclofenac sodium and etodolac are comparable in terms of analgesic efficacy and safety after surgical removal of third molars.

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“…Примером использования этодолака после ортопедической операции может служить РКИ, проведенное А. Pareek и соавт. [20]. В ходе этой работы 158 пациентам, которые перенесли хирургическое вмешательство, был назначен этодолак 400 мг 2 раза в день или диклофенак 50 мг 3 раза в день.…”

unclassified

Etodolac, a Well Known and Actively Used Drug in Different Countries of the World. Would It Be Time for Us?

Каратеев¹

2019

Naučno-praktičeskaâ revmatologiâ

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Etodolac is a nonsteroidal anti-inflammatory drug (NSAID), a moderately selective cyclooxygenase-2 inhibitor, which has been already used in clinical practice for more than 30 years as a universal analgesic and anti-inflammatory agent. Etodolac has proven itself in relieving acute pain associated with injuries and surgical interventions (particularly in dentistry). However, the main point of application of etodolac is long-term pain control in chronic rheumatic diseases, such as osteoarthritis and rheumatoid arthritis. Numerous clinical trials have shown that etodolac is at least not inferior in its therapeutic effect to many other popular representatives of the NSAID group or exceeds them. The main advantage of etodolac is the low frequency of gastrointestinal complications. This review presents the basic data available in the literature on the efficacy and safety of etodolac.

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Comparative evaluation of efficacy and safety of etodolac and diclofenac sodium injection in patients with postoperative orthopedic pain

Abstract: Etodolac can be considered as an effective alternative to traditional NSAIDS in the treatment of post operative pain.

Cited by 4 publications

References 14 publications

Comparative evaluation of analgesic efficacy of tramadol and diclofenac-sodium in post-operative orthopedic patients

Comparative evaluation of analgesic efficacy of tramadol and diclofenac-sodium in post-operative orthopedic patients

Comparison of safety and analgesic efficacy of diclofenac sodium with etodolac after surgical extraction of third molars: a randomized, double-blind, double-dummy, parallel-group study

Etodolac, a Well Known and Actively Used Drug in Different Countries of the World. Would It Be Time for Us?

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