A prospective comparative study on analgesia effect between diclofenac sodium and tramadol hydrochloride used in various orthopedic trauma conditions by applying wong-baker faces pain rating scale in a tertiary care teaching hospital

Abstract

Acute pain in orthopedic trauma should be anticipated and treatment should be a part of every anesthetic plan. In this study we have aimed to assess the comparison of pain management effects between Diclofenac and Tramadol in orthopedic trauma condition along with Wong-Baker Faces Pain Rating Scale to demonstrate which drug provides better efficacy. This prospective case analysis study was conducted during August and September 2019 in the Department of Orthopedics, Gandhi Hospital, Secunderabad with necessary permission. Selected Cases were collected and documented. Outcome was framed after interpreting the data; according to various category and parameters. 30 cases were identified, included and observed in our study considering 15 each in Diclofenac and Tramadol respectively and analyzed for final outcome. Our study shows that male with age group of 21 -40 yrs were predominant in developing orthopedic wound. In our study, we also found cases where both Tramadol and Diclofenac were prescription for the management of pain. Out of 15 patients prescribed with Tramadol, Wong-Baker score was found to be; for 4 patients '0' (no hurt), 6 patients '2' (hurts little bit), 4 patients '4' (hurts little more) and only 1 patient '6' (hurts even more) this shows that pain management with Tramadol was satisfactory. On the other hand, out of 15 cases prescribed with Diclofenac, Wong-Baker score was very less, as 6 cases had a score of '4' (hurts little more), 5 cases had a score of '6' (hurts even more), 4 cases had a score of '8' (hurts whole lot). This indicates that Diclofenac may not be sufficient enough to manage orthopedic pain as compared to Tramadol, as orthopedic pain are acute and very complicated in nature; Tramadol may be the best choice to manage the pain.

Bell’s Palsy—Retroauricular Pain Threshold

“…The pain threshold was determined at 6 retroauricular points located in the RAR on the left and right side, and each point was tested 3 times, with the aim of minimizing the subjectivization of the method. In order to avoid, to the greatest degree possible, patients’ subjectivity, alterations in mimic muscles in certain facial expressions were monitored during examination with the Wong–Baker Faces Pain Rating Scale [ 29 ], minimizing the probability of error. The pain threshold at trigger points represents the arithmetic mean of the values obtained and expressed as kPa/cm 2 .…”