The effectiveness of paracetamol/ tramadol in pain control in elderly wrist surgery and rehabilitation

Distal radius fracture (DRF) is the most common fall-related fracture and the most common fracture of the upper extremities. The purpose of the present study was to ascertain the effectiveness of paracetamol in pain modulation compared with paracetamol/tramadol in postoperative wrist fracture fixation. This interventional cohort study was conducted in a calculated sample size of 60 patients. The chosen criteria to evaluate the two groups during follow-up were: consumption of daily pain drugs; The Short Form (12) Health Survey; Visual analog scale (VAS); the Quick Disability Disabilities of the Arm, Shoulder and Score (QDASH); Complications; and Correlation VAS and QDASH. The endpoints assessment after the infiltrations were: from the moment of trauma to 35 days after the surgery. The first group (n=30) was a group treated by 1 tablet a day of 75 mg Tramadol + 650 mg Paracetamol (PT). The second group (n=30) was a group of patients treated by 1 tablet of paracetamol (P) 1 gr as needed Maximum 3 times a day. At the 35 th day, the mean VAS difference was p=0.027 for PT, also the mean SF-12 difference was p=0.016 for PT. At the 14th day from the surgery, the mean QDASH difference was p=0.042 for PT. Based on a drugs daily use as pain killer, paracetamol/tramadol was significantly better than paracetamol alone with lesser systemic complication. This reported the paracetamol/tramadol combination had more effective pain modulation than alone paracetamol with less complication in postoperative wrist surgery pain management among elderly patients.