Control of pain in the early post-traumatic period in the outpatient practice. Results of the multi-center observational study RAPTOR (Rational Analgesia PostTraumatic: an Observational Research)

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Abstract


Aim. Evaluate the frequency, nature and course of PTP, as well as the effectiveness and safety of NSAIDs in PTP in real clinical practice.

Materials and methods. The assessment of the condition and need for NSAIDs (original meloxicam) in 1115 outpatient patients who suffered a fracture of the radius (32.2%), injury to the knee (35.2%) or ligaments of the ankle (32.6%); women/men 51.5 and 48.5%, average age 46.9±15.5 years. We evaluated the dynamics of pain intensity (on a numerical rating scale – NRS 0–10) at rest and during movement, the preservation of moderate and severe pain, as well as the development of adverse drugs reactions (ADR) to NSAIDs 4–8 weeks after injury.

Results. The average intensity of pain during movement decreased from 7.03±1.66 to 2.21±1.38 (p<0.001), at rest – from 4.46±2.07 to 0.71±0.989 (p<0.001). The number of people with pain severity ≥4 in the NRS in 4–8 weeks after the radius fracture, injury of the knee and ligaments of ankle was 21.0, 16.9 and 11.9%, with moderate or severe impairment of the injured limb – 40.4, 26.2 and 16.3%, respectively. The need for taking NSAIDs up to 7 days was noted in 43.3%, 7–14 days-in 41.8%, more than 2 weeks or constantly in 14.9% of patients. Weak or moderate ADR were observed in 20.8% of patients, mainly dyspepsia and hypertension. Discontinuation of NSAIDs due to ADR was required in only 2.6% of patients. Pain retention ≥4 in NRS was associated with initially expressed pain (>7 in NRS) – OR 2.75 (95% CI 0.83–4.13; p<0.001) and the presence of osteoarthritis of knee and/or hip – OR 1.56 (95% CI 1.03–2.34; p=0.039).

Conclusion. PTP decreases rapidly in most patients after a radius fracture, injury of the knee, and ankle ligament injury while taking the original meloxicam. However, in a significant part of patients, moderate or severe PTP persists after 4–8 weeks, which requires prolonged analgesic therapy and active rehabilitation.


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About the authors

A. E. Karateev

Nasonova Research Institute of Rheumatology

Author for correspondence.
Email: aekarat@yandex.ru
ORCID iD: 0000-0002-1391-0711

Russian Federation, Moscow

д.м.н., зав. лаб. патофизиологии боли и полиморфизма скелетно-мышечных заболеваний

A. M. Lila

Nasonova Research Institute of Rheumatology

Email: aekarat@yandex.ru
ORCID iD: 0000-0002-6068-3080

Russian Federation, Moscow

д.м.н., проф., дир.

N. V. Zagorodnii

Priorova National Medical Research Center of Traumatology and Orthopedics

Email: aekarat@yandex.ru
ORCID iD: 0000-0002-6736-9772

Russian Federation, Moscow

чл.-кор. РАН, д.м.н., проф., дир.

V. N. Amirdzhanova

Nasonova Research Institute of Rheumatology

Email: aekarat@yandex.ru
ORCID iD: 0000-0001-5382-6357

Russian Federation, Moscow

д.м.н., в.н.с. лаб. патофизиологии боли и полиморфизма скелетно-мышечных заболеваний

E. Lu. Pogozheva

Nasonova Research Institute of Rheumatology

Email: aekarat@yandex.ru
ORCID iD: 0000-0001-5103-5447

Russian Federation, Moscow

к.м.н., н.с. лаб. патофизиологии боли и полиморфизма скелетно-мышечных заболеваний

E. S. Filatova

Nasonova Research Institute of Rheumatology

Email: aekarat@yandex.ru
ORCID iD: 0000-0002-2475-8620

Russian Federation, Moscow

к.м.н., н.с. лаб. патофизиологии боли и полиморфизма скелетно-мышечных заболеваний

V. A. Nesterenko

Nasonova Research Institute of Rheumatology

Email: aekarat@yandex.ru
ORCID iD: 0000-0002-7179-8174

Russian Federation, Moscow

м.н.с. лаб. патофизиологии боли и полиморфизма скелетно-мышечных заболеваний

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