NSAIDs Versus Paracetamol Versus Paracetamol + NSAIDs in Traumatic Pain Management
- Conditions
- Acute Pain Due to Trauma
- Interventions
- Registration Number
- NCT03222518
- Lead Sponsor
- University of Monastir
- Brief Summary
The purpose of this study is to:
Compare the effect of paracetamol alone against NSAIDs alone against the association of paracetamol + NSAIDs in the treatment of traumatic pain.
- Detailed Description
Paracetamol, NSAIDs, or a combination of the two molecules are usually prescribed. Patients even use these medications without a prescription. It is not known, however, whether or not NSAIDs have an additional value relative to paracetamol for the treatment of pain.
All patients were assigned in a 1:1:1 ratio. Randomization of subjects was performed centrally according to a computer-generated random code provided by one of investigators who was not involved in any other part of the trial. The patients included were divided into 3 groups: Paracetamol group who received paracetamol 1000 mg orally every 8th hour for 7 days; NSAID group who received piroxicam 20 mg orally twice a day for 7 days, and Paracetamol-NSAID combination who received both treatments at the same doses for 7 days. All protocol treatments were administered in opaque packets with code number according to the randomization list by an independent nurse who was not involved in monitoring or follow-up of the individuals. Data were collected for each patient, including demographics, medical history, and findings of the clinical examination. Injury Severity Score (ISS) whose values range from 0 to 75 was also assessed. Each patient was re-evaluated on the 3rd and 7th day post-trauma (D7) using a telephone contact by a clinical research associates who was blinded to the details of the study to note the following clinical data: pain VNS, ED readmissions for residual pain, need for other analgesics other than those of the protocol, other treatment modalities the patient might have used (adherence to the treatment prescribed), and side effects. In addition patients were asked about their satisfaction with pain control following ED using five point Likert scale: very dissatisfied, not satisfied, neutral, satisfied and very satisfied and about the degree to which they adhered to medication schedule. The principal investigator who was aware of the allocation was not involved in monitoring or recording of the outcomes until the data collection was completed.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1500
- age 18 years or older
- acute (<24 hours) post traumatic pain of the extremity and requiring analgesic treatment upon discharge for pain with intensity >3 on a visual numeric scale
Exclusion criteria:
- open fracture
- head, abdominal, thoracic or polytrauma.
- Need for hospitalization, regular use of paracetamol and NSAIDs during the two weeks before admission to ED
- history of allergy or hypersensitivity to either paracetamol or NSAIDs,
- contraindication to paracetamol or NSAIDs,
- acute /history of GI hemorrhage and renal insufficiency,
- an inability to assess pain intensity according to the VNS.
- Pregnancy
- heart failure
- known hepatic cirrhosis
- known severe renal impairment (Creatinine clearance <30 ml/min)
- swallowing disorders
- Refusal, incapacity or difficulties to consent or to communicate
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Parcetamol Group NSAID The patient receives an envelope containing Paracetamol 1000 mg at the dose of 3 times / day + follow-up sheet + appointment card. NSAID + Paracetamol Group Paracetamol The patient receives an envelope containing NSAID 20 mg piroxicam at a dose of 2 times/day + Paracetamol 1000 mg at a dose of 3 times / day + follow-up sheet + appointment card. NSAID Group paracetamol-NSAID The patient receives an envelope containing NSAID 20 mg piroxicam twice daily / day + follow-up sheet + appointment card. NSAID + Paracetamol Group NSAID The patient receives an envelope containing NSAID 20 mg piroxicam at a dose of 2 times/day + Paracetamol 1000 mg at a dose of 3 times / day + follow-up sheet + appointment card. Parcetamol Group paracetamol-NSAID The patient receives an envelope containing Paracetamol 1000 mg at the dose of 3 times / day + follow-up sheet + appointment card. NSAID Group Paracetamol The patient receives an envelope containing NSAID 20 mg piroxicam twice daily / day + follow-up sheet + appointment card.
- Primary Outcome Measures
Name Time Method new oral analgesic medications needed rate 3 days and 7 days oral analgesic medications other than those of the protocol prescribed by the treating physicians or taken by patients' own volition
- Secondary Outcome Measures
Name Time Method the between-group difference in mean change in VNS score measured from ED discharge (VNS D0) to 7 days later 3 and 7 days \[delta VNS= (VNS D0 - VNS D7 / VNS D0) x 100\]
The appearance of side effects 7 days The appearance of side effects: such as Drowsiness ,Decreased respiratory rate (\<14 c / min), Cutaneous rash, Vomiting,Nausea,pruritus, Dizziness.
• Digestive hemorrhage.the rate of ED readmissions for residual pain 3 and 7 days ED readmissions for residual pain
patient satisfaction assessed by Likert's verbal scale. 3 and 7 days patient satisfaction assessed by Likert's verbal scale.
Trial Locations
- Locations (1)
Monastir University Hospital
🇹🇳Monastir, Tunisia