A Comparative Study of NSAIDs + Opioids V/S NSAIDs + TCAs Perioperatively for Pain Management in the Department of Orthopaedics

Abstract

Background: Perioperative pain is an outcome of inflammation produced by tissue trauma or direct nerve injury. Approximately 70% of patients suffer from moderate to severe pain during the perioperative period. The purpose of this study was to compare the effect of NSAIDs with opioids and NSAIDs with TCAs in the perioperative pain management of orthopedic patients. Method: This was a prospective observational study conducted for six months at the Inpatient Unit Department of Orthopedics of tertiary care Hospital. The participants were randomly divided into two groups each consisting of 40 patients. Group I treated with opioids and Group II treated with TCAs. The pain intensity of perioperative patients was assessed using the visual analogue scale (VAS). Pain outcome was evaluated using the pain outcome questionnaire (POQ). Results: A total of 80 participants were enrolled in this study, of which 54% were males and 46% were females. No significant differences in gender and age were observed between two groups (P>0.05). Each group have shown notable improvement in the pain outcome. Both the study groups have disclosed similar levels of patient satisfaction. Combination regimen proved to be more efficacious in both groups compared to individual regimen (p<0.05). Conclusion: We conclude that both opioids and TCAs have similar potential to manage perioperative pain. Frequency of adverse events was more in patients receiving opioids than TCAs. Addition of NSAID in postoperative management should be increased to reduce the dose of opioids. Hence TCAs are of better choice.