Research Information System
Thesis Type: Doctorate
Institution Of The Thesis: Gazi University, Sağlık Bilimleri Enstitüsü, Turkey
Approval Date: 2009
Thesis Language: Turkish
Student: Yasar Çetin URAL
Supervisor: AHMET KARAMERCAN
Abstract:Soft tissue traumas represent the majority of the trauma cases referring to the emergency and first aid service units. In such patients, the key point of the treatment is to relief the pain quickly and effectively. Our study aims to discuss the effects of and to compare the analgesic effects of paracetamol and tenoxicam each of which is a parenteral analgesics being administered to relief the acute pains caused by soft tissue trauma. The study was participated by 100 patients with soft tissue trauma ranging between 18 and 65 years old and referring to the Emergency Unit of Middle East Technical University (METU). The patients randomly were divided into two groups and the group 1 is defined with tenoxicam (n=50) and the group 2 with paracetamol (n=50). Paracetamol (Perfalgan®) (Bristol-Myers Squibb, Fransa) I.V. was administered by the slow infusion method lasting for 15 minutes and tenoxicam (Tilcotil®) (F. Hoffman-La Roche Ltd, Basel, Đsviçre) I.V was administered by slow injection method. To measure the pain level experienced by the patients, the pain levels experienced before and after the administration were evaluated at 15th, 30th and 60th minutes by a 100 mm horizontal visual analog scale (VAS) (0 mm = no pain, 100 mm = the most severe pain). It was recorded whether there is such side effects as nausea, hypotension, hypertension, respiratory insufficiency, agitation etc. When the pain levels of the patients with soft tissue trauma before and after the administration were analyzed, a significant decrease was observed in the average VAS readings of the both groups at 15th, 30th and 60th minutes both before and after the administration; in other words, the pain was significantly decreased. No statically significant difference between the average VAS readings of the both groups at 15th, 30th and 60th minutes both before and after the intravenous analgesics was observed (p>0.05). None of the patient groups showed such effects as nausea, hypotension, hypertension, agitation, pain at the injection point or local reaction. In conclusion, parenteral paracetamol and parenteral tenoxicam were extremely effective and reliable agents in the treatment of acute pain in the patients referring to the emergency unit due to soft tissue trauma. On one hand, paracetamol can be an analgesic which may be preferred for primary treatment in soft tissue trauma cases since it has less gastrointestinal side effects and has no effect on platelet aggregation and bleeding time. On the other hand, the necessity to administer the parenteral paracetamol by a 15 minute infusion can be considered as a disadvantage, when compared to tonixicam administered by the intravenous bolus method, specifically in terms of such centers having high patient volume. Showing the effectiveness and reliableness in decreasing the acute pain experienced by the patients with soft tissue trauma in a larger mass of patients will be guiding in developing pain treatment algorithms.