Inflammation Research

, Volume 59, Issue 11, pp 989–995 | Cite as

Higher pain scores, similar opioid doses and side effects associated with antipyretic analgesics in specialised tertiary pain care

  • Jörn Lötsch
  • Rainer Freynhagen
  • Nils von Hentig
  • Norbert Griessinger
  • Michael Zimmermann
  • Reinhard Sittl
  • Gerd Geisslinger
Original Research Paper



To evaluate whether non-opioid antipyretic analgesics are associated with lower pain scores, opioid doses and side effects in pain patients in tertiary care.


In a cross-sectional observational study, data from 519 Caucasians (197 men, 322 women; mean age 55.6 ± 15 years) who had undertaken pain therapy for various causes for 77.5 ± 90.8 months, obtained in three separate study centres, was analysed for actual 24-h pain scores, daily opioid doses and the occurrence of side effects.


Of the 519 patients, 352 received opioids and 260 antipyretic analgesics, from whom 154 received both classes and 304 only either class. The administration of non-opioid antipyretic analgesics was associated with higher average pain scores (4.6 ± 2.5 vs 3.9 ± 2.6; P = 0.01), tendentially higher average oral morphine equivalent doses (121.8 ± 162.2 vs 146.7 ± 242.4 mg/d; P = 0.25) and a similar incidence of side effects (P = 0.21). These results were correspondingly seen when analysing the three study centres separately as independent cohorts.


With the caution advised for cross-sectional data, the results dispute a clinical benefit of non-opioid antipyretic analgesics for most chronic pain patients in tertiary care and draw attention towards prospectively re-evaluating the utility of non-opioid antipyretic analgesics in tertiary pain care in a randomised placebo controlled trial.


Eicosanoids and NSAIDs Pain 


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Copyright information

© Springer Basel AG 2010

Authors and Affiliations

  • Jörn Lötsch
    • 1
  • Rainer Freynhagen
    • 2
    • 3
  • Nils von Hentig
    • 1
  • Norbert Griessinger
    • 4
  • Michael Zimmermann
    • 5
  • Reinhard Sittl
    • 4
  • Gerd Geisslinger
    • 1
  1. 1.pharmazentrum frankfurt/ZAFES, Institute of Clinical PharmacologyGoethe-UniversityFrankfurt am MainGermany
  2. 2.Department of AnaesthesiologyUniversitätsklinikum DüsseldorfDüsseldorfGermany
  3. 3.Department of AnaesthesiologyCritical Care Medicine, Pain Therapy and Palliative CareTutzingGermany
  4. 4.Department of AnaesthesiologyUniversitätsklinikum ErlangenErlangenGermany
  5. 5.Department of Anaesthesia, Intensive Care and Pain Therapy/ZAFESGoethe-University HospitalFrankfurtGermany

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