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Comparison of intravenous ibuprofen and tenoxicam efficiency in ankle injury: a randomized, double-blind study

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Abstract

Background and aim

Pain after soft tissue injuries in and around the ankle is a troublesome process in terms of patient comfort and mobilization. The aim of this study was to compare the analgesic efficacy of intravenous ibuprofen and intravenous tenoxicam in patients with acute musculoskeletal pain due to ankle injury.

Methods

We conducted a prospective, double-blind, randomized controlled study in a tertiary hospital. The patients were divided into two groups as those administered IV 400 mg ibuprofen and IV 20 mg tenoxicam. After the treatment of the patients, visual analog scale (VAS) scores were recorded at 15, 30, 60, and 120 min. VAS scores were compared with the effectiveness of drugs, their side effects, and the need for rescue drugs.

Results

One hundred and twenty-four patients were included in the study. There were 62 patients in the tenoxicam group and 62 patients in the ibuprofen group. When VAS scores were compared, it was found that the VAS scores of the ibuprofen group were statistically significantly lower (p < 0.001). When the ΔVAS scores were compared, it was observed that the ΔVAS scores of the ibuprofen group were statistically significantly higher from 30 min (p < 0.001). There was a statistically significant difference in favor of ibuprofen between the two drug groups in terms of the need for rescue analgesics (p < 0.001).

Conclusıon.

The analgesic efficacy of intravenous ibuprofen and tenoxicam is equal after an ankle injury. However, after 30 min of drug administration, ibuprofen provides more effective analgesia than tenoxicam.

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References

  1. Fathi M, Zare MA, Bahmani HR et al (2015) Comparison of oral oxycodone and naproxen in soft tissue injury pain control: a double-blind randomized clinical trial. Am J Emerg Med 33(9):1205–1208. https://doi.org/10.1016/j.ajem.2015.05.021 (PMID: 26166378)

    Article  PubMed  Google Scholar 

  2. Adamson C, Cymet T (1997) Ankle sprains: evaluation, treatment, rehabilitation. Md Med J 46(10):530–537 (PMID: 9392942)

    CAS  PubMed  Google Scholar 

  3. Dizon JM, Reyes JJ (2010) A systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players. J Sci Med Sport 13(3):309–317. https://doi.org/10.1016/j.jsams.2009.05.002

    Article  PubMed  Google Scholar 

  4. Martin RL, Davenport TE, Paulseth S et al (2013) Orthopaedic Section American Physical Therapy Association. Ankle stability and movement coordination impairments: ankle ligament sprains. J Orthop Sports Phys Ther 43(9):A1-40. https://doi.org/10.2519/jospt.2013.0305

    Article  PubMed  Google Scholar 

  5. Sullivan WJ, Panagos A, Foye PM et al (2007) Industrial medicine and acute musculoskeletal rehabilitation. 2. Medications for the treatment of acute musculoskeletal pain. Arch Phys Med Rehabil 88(3 Supp 1):S10–S13. https://doi.org/10.1016/j.apmr.2006.12.009

    Article  PubMed  Google Scholar 

  6. Miner JR, Burton JH (2018) Pain Management. In: Walls RM, Hockberger RS, Gausche -Hill M. Rosen‟s Emergency Medicine: Concepts and Clinical Practice 9th ed. Elsevier, Philadelphia 34 -51

  7. FitzGerald GA, Patrono C (2001) The coxibs, selective inhibitors of cyclooxygenase-2. N Engl J Med 345(6):433–442. https://doi.org/10.1056/NEJM200108093450607

    Article  CAS  PubMed  Google Scholar 

  8. Mazaleuskaya LL, Theken KN, Gong L et al (2015) PharmGKB summary: ibuprofen pathways. Pharmacogenet Genomics 25(2):96–106. https://doi.org/10.1097/FPC.0000000000000113

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Rainsford KD (2009) Ibuprofen: pharmacology, efficacy and safety. Inflammopharmacology 17(6):275–342. https://doi.org/10.1007/s10787-009-0016-x

    Article  CAS  PubMed  Google Scholar 

  10. Yalçınlı S, Kıyan GS, Can Ö et al (2020) Comparison of intravenous ibuprofen and paracetamol efficiency in soft tissue injuries: a randomized, double-blind study. Am J Emerg Med 38(10):2014–2018. https://doi.org/10.1016/j.ajem.2020.06.063

    Article  PubMed  Google Scholar 

  11. Lai PM, Collaku A, Reed K et al (2017) Efficacy and safety of topical diclofenac/menthol gel for ankle sprain: a randomized, double-blind, placebo- and active-controlled trial. J Int Med Res 45(2):647–661. https://doi.org/10.1177/0300060517700322

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Cevik E, Cinar O, Salman N et al (2012) Comparing the efficacy of intravenous tenoxicam, lornoxicam, and dexketoprofen trometamol for the treatment of renal colic. Am J Emerg Med 30(8):1486–1490. https://doi.org/10.1016/j.ajem.2011.12.010

    Article  PubMed  Google Scholar 

  13. Yilmaz A, Sabirli R, Ozen M et al (2019) Intravenous paracetamol versus dexketoprofen in acute musculoskeletal trauma in the emergency department: a randomised clinical trial. Am J Emerg Med 37(5):902–908. https://doi.org/10.1016/j.ajem.2018.08.023

    Article  PubMed  Google Scholar 

  14. Bachmann LM, Kolb E, Koller MT et al (2003 Feb 22) Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ 326(7386):417. https://doi.org/10.1136/bmj.326.7386.417 (PMC:149439 PMID:12595378)

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ridderikhof ML, Saanen J, Goddijn H et al (2019) Paracetamol versus other analgesia in adult patients with minor musculoskeletal injuries: a systematic review. Emerg Med J 36(8):493–500. https://doi.org/10.1136/emermed-2019-208439

    Article  PubMed  Google Scholar 

  16. Jones P, Dalziel SR, Lamdin R et al (2015) Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. Cochrane Database Syst Rev 1(7):CD007789. https://doi.org/10.1002/14651858.CD007789. Update in: Cochrane Database Syst Rev 2020; 12;8:CD007789.

    Article  Google Scholar 

  17. Vuurberg G, Hoorntje A, Wink LM et al (2018) Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med 52(15):956. https://doi.org/10.1136/bjsports-2017-098106

    Article  PubMed  Google Scholar 

  18. Smith HS, Voss B (2012) Pharmacokinetics of intravenous ibuprofen: implications of time of infusion in the treatment of pain and fever. Drugs 72(3):327–337. https://doi.org/10.2165/11599230-000000000-00000

    Article  CAS  PubMed  Google Scholar 

  19. Inc. CP. CALDOLOR (ibuprofen) Injection, for intravenous use [Internet]. [cited 2020 30 Sep]. Available from DailyMed - CALDOLOR- ibuprofen injection (nih.gov)

  20. Kim SY, Lee S, Lee Y et al (2021) Effect of single dose preoperative intravenous ibuprofen on postoperative pain and opioid consumption: a systematic review and meta-analysis. Korean J Anesthesiol 74(5):409–421. https://doi.org/10.4097/kja.21050

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Gallo JM, Gall EP, Gillespie WR et al (1986) Ibuprofen kinetics in plasma and synovial fluid of arthritic patients. J Clin Pharmacol 26(1):65–70. https://doi.org/10.1002/j.1552-4604.1986.tb02905.x

    Article  CAS  PubMed  Google Scholar 

  22. Forouzanfar MM, Mohammadi K, Hashemi B et al (2019) Comparison of intravenous ibuprofen with intravenous ketorolac in renal colic pain management; A Clinical Trial. Anesth Pain Med 9(1):e86963. https://doi.org/10.5812/aapm.86963

    Article  PubMed  PubMed Central  Google Scholar 

  23. Nilsen OG (1994) Clinical pharmacokinetics of tenoxicam. Clin Pharmacokinet 26:16–43

    Article  CAS  PubMed  Google Scholar 

  24. Moore RA, Derry S, Aldington D et al (2015) Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev 28(9):CD008659. https://doi.org/10.1002/14651858.CD008659

    Article  Google Scholar 

  25. Jones RD, Miles W, Prankerd R et al (2000) Tenoxicam i.v. in major gynaecological surgery--pharmacokinetic, pain relief and haematological effects. Anaesth Intensive Care 28(5):491–500. https://doi.org/10.1177/0310057X0002800502

    Article  CAS  PubMed  Google Scholar 

  26. Ozkan HD et al (2021) Effects of paracetamol and tenoxicam on postoperative pain and need for rescue analgesia in root canal treatments performed under general anesthesia: a retrospective study. Meandros Medical and Dental Journal 22(3):282–290

    Article  Google Scholar 

  27. Kocak AO (2019) Intradermal mesotherapy versus systemic therapy in the treatment of musculoskeletal pain: a prospective randomized study. Am J Emerg Med 37(11):2061–2065. https://doi.org/10.1016/j.ajem.2019.02.042

    Article  PubMed  Google Scholar 

  28. Fowler CJ, Naidu PS, Lichtman A et al (2009) The case for the development of novel analgesic agents targeting both fatty acid amide hydrolase and either cyclooxygenase or TRPV1. Br J Pharmacol 156(3):412–419. https://doi.org/10.1111/j.1476-5381.2008.00029.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Emergency Medicine Clinic, Health Sciences University, Adana City Training and Research Hospital, Mithat Ozhan Avenue, 01370, Yuregir, Adana, Turkey

    Gonca Koksaldi Sahin, Muge Gulen, Selen Acehan & Salim Satar

  2. Assisted Reproduction Unit, Andrology Laboratory, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey

    Deniz Aka Satar

  3. Department of Emergency Medicine, Anamur State Hospital, Mersin, Turkey

    Tahsin Erfen

Authors
  1. Gonca Koksaldi Sahin
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  2. Muge Gulen
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  3. Selen Acehan
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  4. Deniz Aka Satar
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  5. Tahsin Erfen
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  6. Salim Satar
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Contributions

GKS, MG, SS, and SA were the coordination researcher of the study and were concerned with study design, implementation, study monitoring, data collection, and interpretation. GKS, SS, MG, SA, TE, and DAS were involved in study design, study monitoring and supervision, and interpretation of data. MG, SA, TE, DKA, and SS were researchers and were involved in data collection and interpretation. GKS, SS, MG, SA, TE, and DAS were involved in the study design, statistical analysis, and data interpretation. All authors reviewed the drafts and approved the final version of the article for submission.

Corresponding author

Correspondence to Salim Satar.

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Ethics approval

Before starting the study, an ethical approval was obtained from the Local Ethics Committee, dated 02.10.2021 and numbered 87.

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Consent form was obtained from all patients.

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The authors declare no competing interests.

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Sahin, G.K., Gulen, M., Acehan, S. et al. Comparison of intravenous ibuprofen and tenoxicam efficiency in ankle injury: a randomized, double-blind study. Ir J Med Sci 192, 1737–1743 (2023). https://doi.org/10.1007/s11845-022-03159-8

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  • DOI: https://doi.org/10.1007/s11845-022-03159-8

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