NSAID ionisation in the management of soft-tissue rheumatism: role played by the drug, electrical stimulation and suggestion.

Four treatments for soft-tissue rheumatism--sham ionisation, placebo ionisation, and pharmacological ionisation with pirprofen (two-dose levels)--were assessed in a randomized double-blind, between-patient controlled trial in 73 outpatients affected by scapulo-humeral periarthritis or elbow epicondylitis. Treatment lasted two weeks (5 sessions a week). Progress was measured by patient's assessment on pain at rest and on movement and by physician's assessment on functional impairment. At two weeks each treatment was associated with a significant degree of improvement; however, pharmacological ionisation produced a significantly higher improvement in symptoms. No differences were detected between sham ionisation and placebo ionisation. These results suggest that the ionisation procedure displays per se a moderate therapeutic effect which seems to be due more to a simple placebo effect than to the biological effect of electricity.

Controlled trial of two nonsteroidal anti-inflammatory drugs in postoperative pain relief: a 12-hour evaluation.

A double-blind, parallel-group trial was performed comparing efficacy and tolerability of two nonsteroidal anti-inflammatory drugs (NSAIDs)--pirprofen and noramidopyrine--in patients with postoperative pain. Thirty-four patients who had undergone orthopedic surgery were treated: 17 were given pirprofen (400 mg/4 ml) and 17 noramidopyrine (1 gm/2 ml). The first dose of medication was administered intramuscularly 30 minutes after the close of anesthesia, and a second administration was allowed six hours later if pain intensity did not decrease by 50% of initial visual analogue scale (VAS) values. Efficacy was tested both by the physician, using a rating scale, and by the patients, using a standard 100-mm VAS just before the administration of trial treatment and 2, 4, 6, and 12 hours later. The number of administrations of trial medication was also used as a criterion of efficacy. Both compounds significantly decreased (P less than 0.001) pain intensity (VAS assessment) over the trial period, but the effect of pirprofen lasted longer than that of noramidopyrine: only one of 17 patients who received pirprofen requested the second administration compared with ten of 17 patients who received noramidopyrine (P = 0.0019). The physician's evaluation performed after six hours evidenced the superiority of pirprofen (P less than 0.02) in comparison with noramidopyrine. No differences were recorded in heart rate, blood pressure, respiratory rate, or body temperature, and no unwanted effect was reported. These data provide evidence that treatment with NSAIDs can result in a well tolerated suppression of postoperative pain.