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International Journal of Orthopaedics Sciences 2020; 6(1): 29-33
E-ISSN: 2395-1958
P-ISSN: 2706-6630
IJOS 2020; 6(1): 29-33
© 2020 IJOS
www.orthopaper.com
Received: 18-11-2019
Accepted: 22-12-2019
Sushanta Kumar Das. M
Pharm
Associate Professor and
Coordinator, Department of
Pharm D, Attached with Gandhi
Medical College and Hospital,
CMR College of Pharmacy,
Medchal, Hyderabad,
Telangana, India
Dr. J Satyanarayana
Professor and Head, Department
of Orthopedics, Gandhi Medical
College & Hospital,
Secunderabad, Telangana, India
Rabia Arshi
Department of Pharm D,
Attached with Gandhi Medical
College & Hospital, CMR College
of Pharmacy, Medchal,
Hyderabad, Telangana, India
Sangishetti Kaveri
Department of Pharm D,
Attached with Gandhi Medical
College & Hospital, CMR College
of Pharmacy, Medchal,
Hyderabad, Telangana, India
Sanjana Yadav Manuka
Department of Pharm. D,
Attached with Gandhi Medical
College & Hospital, CMR College
of Pharmacy, Medchal,
Hyderabad, Telangana, India
Shreya Varanasi Prasanna
Department of Pharm. D,
Attached with Gandhi Medical
College & Hospital, CMR College
of Pharmacy, Medchal,
Hyderabad, Telangana, India
Corresponding Author:
Dr. J Satyanarayana
Professor and Head, Department
of Orthopedics, Gandhi Medical
College & Hospital,
Secunderabad, Telangana, India
A prospective comparative study on analgesia effect
between diclofenac sodium and tramadol hydrochloride
used in various orthopedic trauma conditions by
applying wong-baker faces pain rating scale in a
tertiary care teaching hospital
Sushanta Kumar Das M Pharm, Dr. J Satyanarayana, Rabia Arshi,
Sangishetti Kaveri, Sanjana Yadav Manuka and Shreya Varanasi
Prasanna
DOI: https://doi.org/10.22271/ortho.2020.v6.i1a.1829
Abstract
Acute pain in orthopedic trauma should be anticipated and treatment should be a part of every anesthetic
plan. In this study we have aimed to assess the comparison of pain management effects between
Diclofenac and Tramadol in orthopedic trauma condition along with Wong-Baker Faces Pain Rating
Scale to demonstrate which drug provides better efficacy. This prospective case analysis study was
conducted during August and September 2019 in the Department of Orthopedics, Gandhi Hospital,
Secunderabad with necessary permission. Selected Cases were collected and documented. Outcome was
framed after interpreting the data; according to various category and parameters. 30 cases were identified,
included and observed in our study considering 15 each in Diclofenac and Tramadol respectively and
analyzed for final outcome. Our study shows that male with age group of 21 – 40 yrs were predominant
in developing orthopedic wound. In our study, we also found cases where both Tramadol and Diclofenac
were prescription for the management of pain. Out of 15 patients prescribed with Tramadol, Wong-Baker
score was found to be; for 4 patients ‘0’ (no hurt), 6 patients ‘2’ (hurts little bit), 4 patients ‘4’ (hurts little
more) and only 1 patient ‘6’ (hurts even more) this shows that pain management with Tramadol was
satisfactory. On the other hand, out of 15 cases prescribed with Diclofenac, Wong-Baker score was very
less, as 6 cases had a score of ‘4’ (hurts little more), 5 cases had a score of ‘6’ (hurts even more), 4 cases
had a score of ‘8’ (hurts whole lot). This indicates that Diclofenac may not be sufficient enough to
manage orthopedic pain as compared to Tramadol, as orthopedic pain are acute and very complicated in
nature; Tramadol may be the best choice to manage the pain.
Keywords: Orthopedic trauma, diclofenac, tramadol, Wong-baker faces pain rating scale
Introduction
Acute pain in orthopedic trauma should be anticipated and treatment should be a part of every
anesthetic plan. Analgesic approaches have changed in recent years in part due to patient
expectations, the shift towards ambulatory surgery and shorter hospital stays. The classes of
analgesics used to relieve pain in post-operative cases are non-steroidal anti-inflammatory
drugs, local anesthetics, adrenergic agents and novel methods of applying opioid to
conventional parenteral analgesics
[1]
. Diclofenac is a nonsteroidal anti-inflammatory drug
(NSAID) of the phenyl acetic acid class with anti-inflammatory, analgesic, and antipyretic
properties. Contrary to the action of many traditional NSAIDs, Diclofenac inhibits
cyclooxygenase (COX)-2 enzymes with greater potency than it does COX-1. Similar to other
NSAIDs, Diclofenac is associated with serious dose-dependent gastrointestinal,
cardiovascular, and renal adverse effects. Since its introduction in 1973, a number of different
Diclofenac-containing drug products have been developed with the goal of improving efficacy,
tolerability, and patient convenience.