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A comparison between meptazinol and dextropropoxyphene plus paracetamol in elderly patients with musculoskeletal
Abstract:
The efficacy and acceptability of meptazinol and dextropropoxyphene plus paracetamol were compared in 32 elderly patients with various types of musculoskeletal pain. A double-blind crossover technique was used. After at least 1 week in hospital, the previous analgesic treatment was stopped and single-blind placebo was given for 1 day. Patients then received, at random, 5-days' treatment with either 200 mg meptazinol 4-times daily or 65 mg dextropropoxyphene plus 650 mg paracetamol 4-times daily before being crossed over to the alternative medication for a further 5 days. If necessary, up to 4 tablets a day were allowed of 500 mg aspirin plus 50 mg caffeine as a 'rescue' analgesic. Assessments were made before (on placebo) and at the end of each treatment period of pain severity and effect on patients' sleep, and details recorded of 'rescue' analgesic consumption and any side-effects. At the end of the trial, an overall assessment was made of the effectiveness and tolerance of each treatment and patients were asked which they preferred. The results showed that both treatments reduced pain severity significantly for all the parameters measured; however, most patients needed additional pain relief. Few side-effects were reported during either treatment period.
Insights
Meptazinol and dextropropoxyphene plus paracetamol both effectively reduced musculoskeletal pain in elderly patients. However, most patients required additional pain relief, with few side effects reported for either analgesic.
Area of Science:
- Geriatric Medicine
- Pain Management
- Pharmacology
Background:
- Musculoskeletal pain is common in the elderly.
- Effective and safe analgesia is crucial for this population.
- Comparing different analgesic options is important for clinical practice.
Purpose of the Study:
- To compare the efficacy and acceptability of meptazinol versus dextropropoxyphene plus paracetamol in elderly patients with musculoskeletal pain.
- To evaluate pain severity, sleep quality, and side effects.
- To determine patient preference for either analgesic.
Main Methods:
- Double-blind, crossover study involving 32 elderly patients.
- Patients received either meptazinol or dextropropoxyphene/paracetamol for 5 days, followed by the alternative medication.
- Pain, sleep, rescue analgesic use, and side effects were assessed.
- Rescue analgesic: aspirin plus caffeine.
Main Results:
- Both meptazinol and dextropropoxyphene/paracetamol significantly reduced pain severity.
- Most patients required additional pain relief during the study.
- Few side effects were reported for either treatment.
- Patient preference data was collected.
Conclusions:
- Meptazinol and dextropropoxyphene plus paracetamol are effective in managing musculoskeletal pain in the elderly.
- The need for additional analgesia suggests limitations in the efficacy of single-agent treatments for severe pain.
- Both treatments were well-tolerated, indicating a favorable safety profile.
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