title: Non-Steroid Anti-Inflammatory Drugs Are Better than Acetaminophen on Fever Control at Acute Stage of Fracture.
abstract: In addition to adequate surgical fixation and an aggressive rehabilitation program, pain relief is one of the most critical factors in the acute stage of fracture treatment. The most common analgesics are nonsteroid anti-inflammatory drugs and Acetaminophen, both of which relieve pain and reduce body temperature. In clinical experiences, they exhibit effective pain control; however, their influence on body temperature remains controversial. This study is aimed at determining the effects of analgesics at the acute stage of traumatic fracture by performing a clinical retrospective study of patients with fractures and a fracture animal model. The retrospective study revealed that, in the acetaminophen group, the mean value of postmedication body temperature (BT) was significantly higher than that of the premedication BT. The change in BT was highly related with the medication rather than other risk factors. Forty eight 12-week-old male Wistar rats were divided into 6 groups: a control group, fracture group, fracture-Acetaminophen group, Acetaminophen group, fracture-Arcoxia group, and Arcoxia group. Fracture rats were prepared by breaking their unilateral tibia and fibula. Their inflammation conditions were evaluated by measuring their serum cytokine level and their physiological status was evaluated by estimating their central temperature, heart rate, and mean blood pressure. The hepatic adverse effects were assessed by measuring the serum levels of aspartate aminotransferase (sGOT) and alanine aminotransferase (sGPT). The central temperature in the fracture-Acetaminophen group exceeded that in the groups fed normal saline water or Arcoxia. Accumulated hepatic injury was presented as steadily ascending curves of sGOT and sGPT. Inflammation-related cytokine levels were not higher in the Acetaminophen fracture group and were significantly lower in the fracture-Arcoxia group. Fever appeared to be aggravated by acetaminophen and more related to the elevation of hepatic enzymes than to the change in the inflammation-related cytokines. We suggest that acetaminophen may aggravate fever at the acute stage of fracture. This response is highly related to the accumulated and exacerbated side effects of hepatitis that are caused by the medication and trauma.
authors.affiliation: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, R.O.C.; Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C.
authors.forename: Kuang-Ting
authors.initials: KT
authors.lastname: Yeh
authors.affiliation: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, R.O.C.; Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C.; School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C.
authors.forename: Wen-Tien
authors.initials: WT
authors.lastname: Wu
authors.affiliation: Department of Nursing, Tzu Chi University, Hualien, Taiwan, R.O.C.
authors.forename: Yi-Maun
authors.initials: YM
authors.lastname: Subeq
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C.
authors.forename: Chi-Chien
authors.initials: CC
authors.lastname: Niu
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan, R.O.C.
authors.forename: Kuang-Wen
authors.initials: KW
authors.lastname: Liao
authors.affiliation: Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C.; School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C.
authors.forename: Ing-Ho
authors.initials: IH
authors.lastname: Chen
authors.affiliation: Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Hualien, Taiwan, R.O.C.
authors.forename: Jen-Hung
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, R.O.C.
authors.forename: Ru-Ping
authors.initials: RP
authors.lastname: Lee
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005260:Female; D005334:Fever / Q000150:complications / Q000188:drug therapy*; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051381:Rats; D011921:Rats, Inbred WKY; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen