Abstract
Background
Opioids and NSAIDs are commonly used for pain relief in AP. Opioids carry risk of sphincter of oddi constriction. Although diclofenac prevents post ERCP pancreatitis, few reports of diclofenac associated AP is also present. Although, both tramadol and diclofenac are commonly used for pain relief in AP, no study has evaluated their comparative efficacy and safety.
Materials and methods
46 eligible participants were randomized to either diclofenac or tramadol. Primary objectives our study were improvement in pain intensity (VAS pain score after 1 hr of drug administration), number of patients requiring supplementary analgesia. Secondary objectives were total number of times of supplementary analgesia requirement, time to significant decrease (33%) in VAS pain score from baseline, number of painful days (VAS pain score > 5), VAS pain score on 7th day, side effects, all cause death and complications of pancreatitis between the two groups.
Results
Although46 patients were randomized, the final analysis included 41 participants. 5 patients were withdrawn from the study (intubation = 3, altered sensorium = 2). No significant difference was seem in terms of VAS score after 1 hr of drug administration, number of patients requiring supplementary analgesic, number of painful days. However, time taken to significant reduction of pain was lower in the diclofenac group (p = .028). Both the agents were comparable in terms of safety. Although complications were less in the diclofenac group, the difference was not statistically significant.
Conclusion
Both diclofenac and tramadol are equally effective in controlling pain in AP with similar safety profile.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2R6RS2W
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