title: Efficacy of paracetamol versus diclofenac for Grade II ankle sprains.
abstract: BACKGROUND
  Ankle sprains are usually treated with the RICE protocol often with nonsteroidal anti-inflammatory drugs (NSAID) for pain reduction. We evaluated the effect of diclofenac, an NSAID, versus paracematol in the reduction of pain and acute edema of severe ankle sprains.
  
  
  METHODS
  Ninety patients, 18 to 60 years old, with Grade II acute ankle sprains were randomized into two groups. Group A (45 patients) received for the first 10 days diclofenac 75 mg orally twice per day. Group B (45 patients) received paracetamol 500 mg orally three times per day for the same period. We evaluated ankle joint edema with the Figure-of-Eight method and with the volumetric method, as well as pain with the Visual Analogue Scale (VAS) in both groups.
  
  
  RESULTS
  The patients had no significant differences concerning their baseline values (p > 0.05). The ankle joint edema was decreased in both groups (p < 0.001) but there was more edema in group A than in group B at the third post-traumatic day with both measurement methods (p = 0.028/0.025). By the tenth post-traumatic day no difference was found. Pain decreased in both groups at the third day and at the tenth day (p < 0.001).
  
  
  CONCLUSIONS
  According to these results, diclofenac and paracetamol had the same effect on pain reduction of ankle sprains but more acute ankle edema was present in patients who were treated with diclofenac than in patients who were treated with paracetamol.
authors: GR-61100, Kilkis, Greece. lyrtzischristos@yahoo.gr
authors: Christos
authors: C
authors: Lyrtzis
authors: Konstantinos
authors: K
authors: Natsis
authors: Christos
authors: C
authors: Papadopoulos
authors: Georgios
authors: G
authors: Noussios
authors: Efthymia
authors: E
authors: Papathanasiou
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D016512:Ankle Injuries / Q000145:classification / Q000150:complications / Q000188:drug therapy*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004008:Diclofenac / Q000627:therapeutic use*; D004487:Edema / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D013180:Sprains and Strains / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D000082:Acetaminophen