Research on the comparison of Non-steroidal anti-inflammatory drugs (NSAID) and opioids in low back pain
Abstract
INTRODUCTION: Opioids and Non-steroidal anti-inflammatory drugs (NSAID) are used to manage low back pain. However, it has been reported in some researches that opioids have fewer side effects than NSAID.
METHODS: Patient files of all the patients admitted to the emergency department of Ufuk University ethics committee on 23.03.2018 and applied with severe nontraumatic low back pain between 01.01.2015 and 01.01.2016 were examined retrospectively. It was aimed to evaluate the efficacy of these two drugs in the treatment of pain by evaluating the responses of these patients with visual analogue scale scales.
RESULTS: A total of 138 patients among 911 patients experiencing low back pain were included in the study. 81 patients received 75 mg of diclofenac sodium therapy alone, 57 patients received only Petidin hydro- chloride treatment. 64 (46.4%) of the patients were male and 74 (53.6%) were female. It was found that there was no statistically significant correlation between pain scores of 75 mg of diclofenac sodium imide treatment applied and Pethidine hydrochloride applied patient groups (p > 0.05). There was no statistically significant correlation between pain scores and genders of 75 mg of diclofenac sodium imide treatment applied and Pethidine hydrochloride applied patient groups (p > 0.05). The difference between patients’ referral scores and pain scores after 45 minutes (75 mg diclofenac sodium imide and petidine hydrochloride imide) were found to be statistically insignificant (p > 0.05). There was no statistically significant difference in the analyzed results of the efficacy of 75 mg diclofenac sodium treatment related to gender (p > 0.05). There was no statistically significant difference in the analyzed results of the efficacy of Pethidine hydrochlo- ride treatment related to sex (p > 0.05).
CONCLUSIONS: Opioids have fewer side effects than NSAIDs in short period management of the pain, and they may be used for low back pain management in emergency services instead of NSAIDs.
Keywords: opioidNSAIDlow back painpain managementemergency
References
- Rizzardo A, Miceli L, Bednarova R, et al. Low-back pain at the emergency department: still not being managed? Ther Clin Risk Manag. 2016; 12: 183–187.
- Edwards J, Hayden J, Asbridge M, et al. Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2017; 18(1): 143.
- Baharuddin KA, Mohamad N, Nik Abdul Rahman NH, et al. Assessing Patient Pain Scores in the Emergency Department. Malays J Med Sci. 2010; 17(1): 17–22.
- Singer A, Kowalska A, Thode H. Ability of Patients to Accurately Recall the Severity of Acute Painful Events. Academic Emergency Medicine. 2001; 8(3): 292–295.
- Karcıoğlu Ö. Management of pain and practice of analgesia in the emergency setting. Turkiye Aile Hekimligi Dergisi. 2010; 14(2): 53–63.
- Chou R, Qaseem A, Snow V, et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine. 2007; 147(7): 478.
- Gottlieb M, Njie A. Comparison of naproxen with cyclobenzaprine, oxycodone-acetaminophen, and placebo for the treatment of acute low back pain. CJEM. 2016; 18(6): 491–494.
- White AP, Arnold PM, Norvell DC, et al. Pharmacologic management of chronic low back pain: synthesis of the evidence. Spine (Phila Pa 1976). 2011; 36(21 Suppl): S131–S143.
- Biyik I, Gülcüler M, Karabiga M, et al. Efficacy of gabapentin versus diclofenac in the treatment of chest pain and paresthesia in patients with sternotomy. Anadolu Kardiyol Derg. 2009; 9(5): 390–396.
- Yeganeh Mogadam A, Fazel MR, Parviz S. Comparison of analgesic effect between gabapentin and diclofenac on post-operative pain in patients undergoing tonsillectomy. Arch Trauma Res. 2012; 1(3): 108–111.