Analgesic efficacy of tramadol/acetaminophen and propoxyphene/acetaminophen for
relief of postoperative wound pain.
Author(s): Lin FS, Lin WY, Lai CH, Chen CY, Lin CP, Lin TF, Sun WZ.
Affiliation(s): Department of Anesthesiology, National Taiwan University Hospital, Taipei,
Taiwan.
Publication date & source: 2012, Acta Anaesthesiol Taiwan. , 50(2):49-53
BACKGROUND/PURPOSE: Weak opioid combined with acetaminophen (APAP) has been
proven to provide better analgesic efficacy and cause fewer complications than
either drug alone. However, there are questions about whether different opioids,
tramadol and propoxyphene, provide similar efficacy or safety. Thus, we
investigated Ultracet (37.5 mg tramadol/325 mg APAP) and Depain-X (65 mg
propoxyphene/650 mg APAP). The primary aims of this study were to compare the
analgesic efficacy and adverse effects of single-dose oral Ultracet versus
Depain-X in acute postoperative pain.
MATERIALS AND METHODS: This was a randomized, open-label, active-controlled
parallel study on patients with postsurgical pain. Sixty patients who sustained
moderate postsurgical pain (visual analog scale(3)3 cm) after undergoing
implantation of venous access were randomized to two groups to receive either
Ultracetor Depain-X for postoperative analgesia. Assessment items included pain
intensity and pain relief ratings at the first 4 hours, and adverse events.
RESULTS: There were initially 107 patients who were enrolled in this trial, but
up to 45 (42.1%) of them were withdrawn during the study. In these 62 patients
who complied with treatment (Ultracet: Depain-X = 29: 33), pain relief scale
indicated that Ultracet could provide a better analgesic effect than Depain-X
provided at 1 hour (p < 0.05). At 4 hours, the pain score in the Ultracet group
was significantly lower than that in the Depain-X group (p < 0.05). Adverse
events, such as drowsiness, dizziness, and skin itching did not differ in both
groups.
CONCLUSION: Among patients with mild to moderate postoperative wound pain,
single-dose Ultracet can provide slightly better analgesic efficacy than Depain-X
in terms of onset and duration. Depain-X is no longer marketed in Europe,
America, Taiwan and other countries, therefore, Ultracet can serve as a good
substitute for treating postoperative pain.
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