Effects of Topical Diclofenac Plus Heparin (Dhep+H Plaster) on Somatic Pain Sensitivity in Healthy Subjects With a Latent Algogenic Condition of the Lower Limb.

Objective To evaluate whether a diclofenac epolamine + heparin topical (plaster) is more effective than diclofenac plaster alone in reducing deep somatic hyperalgesia in subjects without spontaneous pain and whether the effect is linked to or independent of the anti-edematous action of heparin. Desi...

Descripción completa

Detalles Bibliográficos
Publicado en:Pain Practice Vol. 15; no. 1; pp. 58 - 68
Autores principales: Affaitati, Giannapia, Fabrizio, Alessandra, Frangione, Valeria, Lanzarotti, Arturo, Lopopolo, Mariangela, Tafuri, Emmanuele, Lapenna, Domenico, Giamberardino, Maria Adele, Costantini, Raffaele
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Wiley-Blackwell Jan2015
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103870424&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 103870424
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        15307085
        HYN
      jtl: Pain Practice
      issn: 15307085
      maglogo: Y
    pubinfo:
      dt: Jan2015
      vid: 15
      iid: 1
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        103870424
        100256860
        10.1111/papr.12161
        NLM24433223
        103870424
      ppf: 58
      ppct: 10
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Effects of Topical Diclofenac Plus Heparin (Dhep+H Plaster) on Somatic Pain Sensitivity in Healthy Subjects With a Latent Algogenic Condition of the Lower Limb.
      aug:
        au:
          Affaitati, Giannapia
          Fabrizio, Alessandra
          Frangione, Valeria
          Lanzarotti, Arturo
          Lopopolo, Mariangela
          Tafuri, Emmanuele
          Lapenna, Domenico
          Giamberardino, Maria Adele
          Costantini, Raffaele
        affil: Ce.S.I., 'G. D'Annunzio' Foundation; Department of Medicine and Science of Aging, University of Chieti
      sug:
        subj:
          Diclofenac Administration and Dosage
          Heparin
          Drug Combinations
          Administration, Topical
          Muscle Pain Prevention and Control
          Hyperalgesia Drug Therapy
          Pain Threshold
          Leg Pathology
          Human
          Randomized Controlled Trials
          Prospective Studies
          Double-Blind Studies
          Female
          Male
          Descriptive Statistics
          Random Assignment
          Academic Medical Centers
          Italy
          Adolescence
          Young Adult
          Adult
          Middle Age
          Aged
          Algometry Methods
          Electric Stimulation Methods
          Data Analysis Software
          T-Tests
          Analysis of Variance
          Post Hoc Analysis
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Objective To evaluate whether a diclofenac epolamine + heparin topical (plaster) is more effective than diclofenac plaster alone in reducing deep somatic hyperalgesia in subjects without spontaneous pain and whether the effect is linked to or independent of the anti-edematous action of heparin. Design Prospective, double-blind, randomized and controlled, four-arm parallel design trial. Subjects One hundred and four patients (84 women, 20 men, mean age 42.2 ± 13.3 years), with deep somatic hyperalgesia in one thigh, randomly assigned to one of 4 groups of 26 each. Intervention Each group underwent one of the following plaster treatments on one thigh: diclofenac+heparin; diclofenac; heparin; placebo, for 7 days, renewing the plaster every 24 hours. Outcome Measures Before treatment (day 1), at day 4 and day 8, assessment of (a) pressure and electrical pain thresholds of vastus lateralis and overlying subcutis and skin; and (b) structure/thickness of subcutis and muscle with ultrasounds at the same level. Results During treatment, in placebo and heparin, no significant threshold changes, except subcutis thresholds which increased slightly ( P < 0.02); in diclofenac and diclofenac+heparin, significant increase in all thresholds (0.0001 < P < 0.04). Electrical muscle pain thresholds increased significantly more in diclofenac+heparin than in diclofenac, heparin, and placebo (0.0001 < P < 0.04). In all groups: no edema and thickness changes at ultrasounds in muscle and subcutis. Conclusions Topical diclofenac+heparin is significantly more effective than diclofenac alone in reducing muscle hyperalgesia in subjects without spontaneous pain, independently of the anti-edematous action of heparin. The results provide a rationale for the use of diclofenac+heparin also in algogenic conditions without evident signs of injury/edema/hematoma.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N