Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, pethidine & diclofenac sodium application for pain relief during fractional curettage: A randomized controlled trial

Comparative Study of the Effect of Lidocaine Spray and Ice Spray on the Pain Intensity During Intramuscular Injection: A Randomized Clinical Trial

BACKGROUND

Intramuscular injection is one of the most common, invasive, and painful ways to deliver medicine to the body.

AIM

Since one of the nurse's duties is to employ different methods to reduce pain caused by treatment procedures, this study was conducted to determine the effect of lidocaine spray and ice spray on pain intensity at the muscle injection site.

METHOD

A clinical trial was performed on 90 patients presenting to outpatient clinics of Neyshabur hospitals. The samples were selected using a computerized table of random numbers, and each participant was randomly assigned to one of the control, lidocaine spray, and ice spray groups. Pain severity was measured immediately after intramuscular injection using a numerical pain scale. Descriptive statistics along with statistical tests (chi-square, Fisher, etc.) were used to analyze the data in the R environment version 3.6.2. Ordinal logistic regression was used to compare pain intensity in the three groups by adjusting the effect of age variables and sensory disorders.

RESULTS

The mean pain intensity was 3.44 without intervention, 2.63 with lidocaine spray, and 2.27 with ice spray. Statistical tests indicated a significant difference in pain intensity of intramuscular injection between the ice group and the control group (p = .010). Although lidocaine spray reduced the pain intensity, its effect was insignificant compared with the control group.

CONCLUSIONS

Both ice and lidocaine spray can be effectively used to reduce the intensity of intramuscular injection pain; however, it seems that ice spray is a more effective, safe, and affordable method.

A review of dexketoprofen trometamol in acute pain

OBJECTIVE

Dexketoprofen trometamol is a modified non-selective COX inhibitor with a rapid onset of action that is available as both oral and parenteral formulations. The aim of this narrative review was to assess the efficacy and tolerability/safety of dexketoprofen trometamol in acute pain states using the best available published scientific evidence (randomized controlled clinical trials and systematic reviews/meta-analyses).

METHODS

Literature retrieval was performed via Medline, Embase and the Cochrane Library (from inception up to March 2017) using combinations of the terms "randomized controlled trials", "dexketoprofen", "celecoxib", "etoricoxib", "parecoxib" and "acute pain".

RESULTS

Single-dose dexketoprofen trometamol provides effective analgesia in the treatment of acute pain, such as postoperative pain (dental and non-dental surgery), renal colic, acute musculoskeletal disorders and dysmenorrhea, and reduces opioid consumption in the postoperative setting. It has a rapid onset of action (within 30 minutes) and is well tolerated during short-term treatment. Direct comparisons with COX-2 inhibitors are lacking; however, the efficacy and tolerability of single-dose dexketoprofen trometamol appears to be consistent with that seen with celecoxib, etoricoxib and parecoxib in the acute pain setting.

CONCLUSION

In conclusion, dexketoprofen trometamol appears to provide similar analgesic efficacy to COX-2 inhibitors when used to treat acute pain, has a rapid onset of action, is well tolerated, and has an opioid-sparing effect when used as part of a multimodal regimen in the acute pain setting.

The Efficacy of Lidocaine Spray in Pain Relief during Outpatient-Based Endometrial Sampling: A Randomized Placebo-Controlled Trial

Abnormal vaginal bleeding is one of the most frequent problems found in gynecology. Endometrial histopathology is needed for definite diagnosis. It was obtained either from endometrial tissue sampling or from standard uterine curettage. Office endometrial tissue sampling is an easy and low morbid procedure. It is usually associated with pain and discomfort. Topical anesthetic agent is needed for pain relieving. This study was conducted in outpatient gynecology clinic, Thammasat University Hospital, Thailand. It was a double blind randomized controlled trial. A total of 140 participants were enrolled in study and control group. Each group consisted of 70 cases. Study group received topical spray of 10% lidocaine (40 mg) before endometrial aspiration. Topical spray of 0.9% normal saline was performed in control group. Novak curettage was an application for endometrial tissue obtaining in this study. Visual analog scale (10cm-VAS) was used for pain evaluation. Demographic character of both groups showed no statistical difference. The percentage of participants who had severe pain (VAS≥7) during tenaculum application and Novak curettage insertion and during procedure were 28.5% (20/70) versus 12.9% (9/70), 55.7% (39/70) versus 38.5% (27/70), and 78.5% (55/70) versus 60% (42/70) in control and study group, respectively. Both groups had no significant differences of postoperative pain at 15 minutes and 2 hours. This study indicates that topical lidocaine spray can relieve pain during endometrial tissue sampling.

[Dexketoprofen trometamol in dorsalgia treatment]

Lower back pain (LBP) remains an important problem due to its high prevalence. LBP is the fifth in frequency among reasons for seeking treatment, and one of the most common among the chronic pain syndromes. Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered to be the «gold standard» in relieving back pain. In treatment of acute musculoskeletal pain syndromes, special attention is drawn to drugs characterized by high analgesic activity and a short half-life. Among the drugs in this group, dexketoprofen (a derivative of propionic acid), a water-soluble salt of the dextrorotatory enantiomer of ketoprofen, deserves special attention. Over the last decade, a number of studies have shown the high efficacy of dexketoprofen trometamol.