CLINICAL ASSESSMENT OF TRAMADOL ANALGESIC EFFECT IN COMPARISON TO COMBINATION OF PARACETAMOL AND CHLORZOXAZONE IN ACUTE NEUROPATHIC PAIN IN IRAQI PATIENTS

Abstract

Neuropathic pain (NP) is pain initiated or caused by a primary lesion or dysfunction in the nervous system. Many common diseases, injuries, and interventions cause NP by producing lesions in somatosensory pathways in the peripheral or central nervous system. Its treatment is complex with often inadequate response to treatment. Tramadol has been considered as the analgesic of choice for patients in moderate to severe pain and used as a control treatment. Combination of the skeletal muscle relaxant chlorzoxazone and the non-opioid analgesic paracetamol was investigated for their efficacy of blocking NP in comparison with the control treatment. Forty eight patients with age range 20-40 years old (27 males and 21 females) who were treated for acute neuropathic pain in Dijlah rehabilitation hospital were involved. The efficacy of treatment was assessed using 0-10 numeric pain scale. The safety issue of drugs was assessed by investigating liver function test, serum creatinine and hematological parameters. The results revealed that there is no statistical difference (p≥ 0.05) in pain treatment efficacy between the investigated treatment and the control group. The safety issue showed that there is no statistical difference (p≥ 0.05) between the measurement of laboratory data before and after time schedule of the treatment. It is concluded that chlorzoxazone / paracetamol combination therapy is an effective and safe treatment for neuropathic pain comparable to tramadol.