OBJECTIVE

To compare analgesic effectiveness and safety of a fixed combination of diclofenac and orphenadrine with dexketoprofen and tolperizone in patients with acute non-specific pain in the neck, lower back, and in ones with cervical and lumbar radicular pain.

MATERIAL AND METHODS

The study included 36 patients aged 30-60 years suffering from acute non-specific pain in the neck, lower back, as well as cervical and lumbar radicular pain. Patients were randomized into 2 groups. In the 1st group, neodolpasse (diclofenac 75 mg and orphenadrine 30 mg) was injected intravenously daily (2 days). For treatment optimization, 2 subgroups were distinguished with single and double administration of neodolpasse per a day. In the 2nd group (n=21), dexketoprofen (50 mg twice a day) and tolperizone (100 mg daily) were injected intramuscularly for 3 days.

RESULTS

Baseline VAS score was similar in all groups. More significant analgesic effect was observed on the 2nd day of treatment with neodolpasse. Double injections of this drug were followed by more significant analgesic effect compared to a single administration. There were no local adverse effects after injections. Dyspeptic disorders (heartburn, decreased appetite) were identified in 2 patients (5.5%). Dizziness and tremor were seen in 1 case after the second injection. Drowsiness was common after intravenous infusion (4 (11.1%) cases). There was an imperceptible increase in systolic pressure immediately after infusion. Diastolic pressure was stable throughout the treatment course.

CONCLUSION

Combination of orphenadrine and diclofenac is a highly effective and safe therapy for acute spondylogenic pain syndromes. Thanks to the impact on various pathogenetic mechanisms, this drug is followed by fast analgesic effect. Therefore, considerable reduction in analgesic consumption may be expected.