title: Effectiveness of diclofenac, ketorolac and etoricoxib in the treatment of acute pain from ankle fracture.
abstract: Tissue degeneration, infection, inflammation, cancer, trauma, surgery and limb fractures all produce pain. Each of these physiological abnormalities requires a therapeutic approach different from the last. In acute pain, caused by fracture, several classes of analgesics have been utilized. These basic remedies for analgesia, however, are still confined to a small number of medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics and opioids. In addition, most of these drugs have side effects, limiting their use in clinical practice. The purpose of this study was to compare the efficacy of three NSAIDs to relief acute pain caused by ankle fracture. Sixty subjects with ankle fracture were randomized to receive ketorolac, diclofenac, or etoricoxib, every 12 hours in a prospective, double-blind study. Forty-nine patients completed the study. The subjects' assessments of ankle pain on the visual analog scale and a Likert scale showed a significant reduction from baseline over 24 hr, regardless the treatment group. All treatments showed a similar profile in pain reduction. Etoricoxib, diclofenac and ketorolac twice daily are a rapid and effective treatment for acute pain. All the regimens were well tolerated in this study.
authors: Area Académica de Medicina del Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico. mario_i_ortiz@hotmail.com
authors: Mario I
authors: MI
authors: Ortiz
authors: Raúl
authors: R
authors: Monroy-Maya
authors: Marisela
authors: M
authors: Soto-Ríos
authors: Lourdes Cristina
authors: LC
authors: Carrillo-Alarcón
authors: Héctor A
authors: HA
authors: Ponce-Monter
authors: Eduardo
authors: E
authors: Rangel-Flores
authors: José J
authors: JJ
authors: Loo-Estrada
authors: Jeannett A
authors: JA
authors: Izquierdo-Vega
authors: Manuel
authors: M
authors: Sánchez-Gutiérrez
mesh_terms: D059787:Acute Pain / Q000188:drug therapy*; D000328:Adult; D016512:Ankle Injuries / Q000188:drug therapy* / Q000503:physiopathology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004008:Diclofenac / Q000627:therapeutic use*; D004311:Double-Blind Method; D000077613:Etoricoxib; D050723:Fractures, Bone / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011725:Pyridines / Q000627:therapeutic use*; D013450:Sulfones / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D011725:Pyridines; D013450:Sulfones; D004008:Diclofenac; D000077613:Etoricoxib; D020910:Ketorolac