Efficacy of Paracetamol versus Diclofenac for Grade II Ankle Sprains

Lyrtzis, Christos; Natsis, Konstantinos; Papadopoulos, Christos; Noussios, Georgios; Papathanasiou, Efthymia

doi:10.3113/fai.2011.0571

Cited by 23 publications

(15 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was no significant difference in pain reduction. Two other RCT’s from 2007 and 2011 found no significant difference in decrease in Visual Analogue Scale (VAS) in 100 and 90 patients, treated for ankle sprains five and ten days respectively with diclofenac 150 mg or paracetamol 1500 mg daily [25,26]. It is questionable whether these results can be extrapolated, as the daily dose paracetamol used in The Netherlands is much higher.…”

Section: Discussionmentioning

confidence: 99%

The PanAM study: a multi-center, double-blinded, randomized, non-inferiority study of paracetamol versus non-steroidal anti-inflammatory drugs in treating acute musculoskeletal trauma

et al. 2013

View full text Add to dashboard Cite

BackgroundAcute musculoskeletal trauma, including strains, sprains or contusions, occur frequently. Pain management is a crucial component of treatment. However, there is no convincing evidence which drug is superior in managing pain in these patients. The aim of the PanAM Study is to compare analgesic efficacy of three strategies of pain management: paracetamol, diclofenac, or a combination of both in patients with acute musculoskeletal trauma.Methods/designThe PanAM Study is a multi-center, double blind randomized controlled trial with non-inferiority design. Included are adult patients presenting to an academic, urban Emergency Department or to a General Practice with acute, blunt, traumatic limb injury. In total, 547 patients will be included using a predefined list of exclusion criteria, to be allocated by randomization to treatment with paracetamol + placebo diclofenac, diclofenac + placebo paracetamol or paracetamol + diclofenac. The hypothesis is that paracetamol will not be inferior to treatment with diclofenac, or the combination of both. Primary outcome will be between-group differences in decrease in pain, measured with Numerical Rating Scales at baseline and at 90 minutes after study drug administration. Secondary outcomes are Numerical Rating Scales at 30 and 60 minutes and measured frequently during three consecutive days after discharge; occurrence of adverse effects; patient satisfaction and an analysis of quality of life and cost-effectiveness. Recruitment started July 2013 and is expected to last a year.DiscussionWith this multi-center randomized clinical trial we will investigate whether treatment with paracetamol alone is not inferior to diclofenac alone or a combination of both drugs in adult patients with acute musculoskeletal trauma. The main relevance of the trial is to demonstrate the benefits and risks of three commonly used treatment regimens for musculoskeletal trauma. Data that lead to the prevention of severe Non-Steroidal Anti-Inflammatory Drugs-related adverse effects might be gathered.Trial registrationDutch Trial Register (http://www.trialregister.nl): NTR3982.EudraCT database (http://www.clinicaltrialsregister.eu): 201300038111.

show abstract

Section: Discussionmentioning

confidence: 99%

The PanAM study: a multi-center, double-blinded, randomized, non-inferiority study of paracetamol versus non-steroidal anti-inflammatory drugs in treating acute musculoskeletal trauma

et al. 2013

View full text Add to dashboard Cite

show abstract

“…17,[28][29][30][31][32][33][34][35][36] All of the more recent studies were randomized, double-blind, double-dummy, parallelgroup designs. 17,[28][29][30][31][32][33][34][35][36] Half of the studies were placebo-controlled, superiority studies. 17,29,30,34,35 The majority (nine studies) had pain-on-movement intensity difference from baseline (100 mm VAS) as the primary or secondary endpoint.…”

Section: Discussionmentioning

confidence: 99%

“…17,29,30,34,35 The majority (nine studies) had pain-on-movement intensity difference from baseline (100 mm VAS) as the primary or secondary endpoint. 17,[28][29][30][31][32][33]35,36 Seven studies assessed this endpoint on either day 3 or 4. [28][29][30][31][32]35,36 With the above limitations in mind, a comparison can be made on overall clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

A randomized, double-blind, placebo-controlled multicentre study to evaluate the efficacy and safety of diclofenac 4% spray gel in the treatment of acute uncomplicated ankle sprain

Predel

Giannetti²,

Seigfried³

et al. 2013

J Int Med Res

View full text Add to dashboard Cite

show abstract

“…Seven trials 97,98,105,109,112,116,118 evaluated opioid therapy (KQ 3a and 3c), 13 trials [93][94][95][96]99,[101][102][103]107,108,111,120,122 evaluated a nonopioid medication versus nonpharmacologic treatment or another nonopioid (KQ 3i and 3j), and 10 trials 100,104,106,110,[113][114][115]117,119,121 (KQ 3m and 3n) evaluated nonpharmacologic treatment versus an inactive control or another nonpharmacologic treatment. Twelve trials 95,99,101,[104][105][106]109,110,113,117,119,121 evaluated patients with ankle sprain, 3 trials 98,100,115 fractures, 1 trial 93 acute rotator cuff tear, and 14 trials 94,96,97,102,103,107,108,…”

Section: Summary Of Findingsmentioning

confidence: 99%

“…The duration of pain was <7 days in 12 trials 93,95,96,99,[101][102][103][104]109,110,117,119,121,122 was <14 days in 2 trials, 94,97 and not described in 14 trials. 98,100,[105][106][107][108][111][112][113][114][115][116]118,120 The duration of treatment ranged from a single dose or treatment session 98,107,117,118 to 8 weeks. 104 The duration of followup was less than 1 week in 16 trials, 95,[98][99][100][101][102][103][104][105]107,[109][110][111]116,118,120 1 week to <4 weeks in 15 trials, …”

Section: Summary Of Findingsmentioning

confidence: 99%

Treatments for Acute Pain: A Systematic Review

Chou¹,

Wagner²,

Ahmed³

et al. 2020

View full text Add to dashboard Cite

Objectives. To evaluate the effectiveness and comparative effectiveness of opioid, nonopioid pharmacologic, and nonpharmacologic therapy in patients with specific types of acute pain, including effects on pain, function, quality of life, adverse events, and long-term use of opioids. Data sources. Electronic databases (Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews) to August 2020, reference lists, and a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) of outpatient therapies for eight acute pain conditions: low back pain, neck pain, other musculoskeletal pain, neuropathic pain, postoperative pain following discharge, dental pain (surgical or nonsurgical), pain due to kidney stones, and pain due to sickle cell disease. Meta-analyses were conducted on pharmacologic therapy for dental pain and kidney stone pain, and likelihood of repeat or rescue medication use and adverse events. The magnitude of effects was classified as small, moderate, or large using previously defined criteria, and strength of evidence was assessed. Results. One hundred eighty-three RCTs on the comparative effectiveness of therapies for acute pain were included. Opioid therapy was probably less effective than nonsteroidal anti-inflammatory drugs (NSAIDs) for surgical dental pain and kidney stones, and might be similarly effective as NSAIDs for low back pain. Opioids and NSAIDs were more effective than acetaminophen for surgical dental pain, but opioids were less effective than acetaminophen for kidney stone pain. For postoperative pain, opioids were associated with increased likelihood of repeat or rescue analgesic use, but effects on pain intensity were inconsistent. Being prescribed an opioid for acute low back pain or postoperative pain was associated with increased likelihood of use of opioids at long-term followup versus not being prescribed, based on observational studies. Heat therapy was probably effective for acute low back pain, spinal manipulation might be effective for acute back pain with radiculopathy, acupressure might be effective for acute musculoskeletal pain, an opioid might be effective for acute neuropathic pain, massage might be effective for some types of postoperative pain, and a cervical collar or exercise might be effective for acute neck pain with radiculopathy. Most studies had methodological limitations. Effect sizes were primarily small to moderate for pain, the most commonly evaluated outcome. Opioids were associated with increased risk of short-term adverse events versus NSAIDs or acetaminophen, including any adverse event, nausea, dizziness, and somnolence. Serious adverse events were uncommon for all interventions, but studies were not designed to assess risk of overdose, opioid use disorder, or long-term harms. Evidence on how benefits or harms varied in subgroups was lacking. Conclusions. Opioid therapy was associated with decreased or similar effectiveness as an NSAID for some acute pain conditions, but with increased risk of short-term adverse events. Evidence on nonpharmacological therapies was limited, but heat therapy, spinal manipulation, massage, acupuncture, acupressure, a cervical collar, and exercise were effective for specific acute pain conditions. Research is needed to determine the comparative effectiveness of therapies for sickle cell pain, acute neuropathic pain, neck pain, and management of postoperative pain following discharge; effects of therapies for acute pain on non-pain outcomes; effects of therapies on long-term outcomes, including long-term opioid use; and how benefits and harms of therapies vary in subgroups.

show abstract

Efficacy of Paracetamol versus Diclofenac for Grade II Ankle Sprains

Abstract: According to these results, diclofenac and paracetamol had the same effect on pain reduction of ankle sprains but more acute ankle edema was present in patients who were treated with diclofenac than in patients who were treated with paracetamol.

Cited by 23 publications

References 25 publications

The PanAM study: a multi-center, double-blinded, randomized, non-inferiority study of paracetamol versus non-steroidal anti-inflammatory drugs in treating acute musculoskeletal trauma

The PanAM study: a multi-center, double-blinded, randomized, non-inferiority study of paracetamol versus non-steroidal anti-inflammatory drugs in treating acute musculoskeletal trauma

A randomized, double-blind, placebo-controlled multicentre study to evaluate the efficacy and safety of diclofenac 4% spray gel in the treatment of acute uncomplicated ankle sprain

Treatments for Acute Pain: A Systematic Review

Contact Info

Product

Resources

About