Controlled trial of two nonsteroidal anti-inflammatory drugs in postoperative pain relief: a 12-hour evaluation

A double-blind, parallel-group trial was performed comparing efficacy and tolerability of two nonsteroidal anti-inflammatory drugs (NSAIDs)--pirprofen and noramidopyrine--in patients with postoperative pain. Thirty-four patients who had undergone orthopedic surgery were treated: 17 were given pirprofen (400 mg/4 ml) and 17 noramidopyrine (1 gm/2 ml). The first dose of medication was administered intramuscularly 30 minutes after the close of anesthesia, and a second administration was allowed six hours later if pain intensity did not decrease by 50% of initial visual analogue scale (VAS) values. Efficacy was tested both by the physician, using a rating scale, and by the patients, using a standard 100-mm VAS just before the administration of trial treatment and 2, 4, 6, and 12 hours later. The number of administrations of trial medication was also used as a criterion of efficacy. Both compounds significantly decreased (P less than 0.001) pain intensity (VAS assessment) over the trial period, but the effect of pirprofen lasted longer than that of noramidopyrine: only one of 17 patients who received pirprofen requested the second administration compared with ten of 17 patients who received noramidopyrine (P = 0.0019). The physician's evaluation performed after six hours evidenced the superiority of pirprofen (P less than 0.02) in comparison with noramidopyrine. No differences were recorded in heart rate, blood pressure, respiratory rate, or body temperature, and no unwanted effect was reported. These data provide evidence that treatment with NSAIDs can result in a well tolerated suppression of postoperative pain.