Abstract
According to the high consumption of the mixture of B vitamins and diclofenac in several
countries, this combination has constituted a frequently used option in pain therapy
from inflammatory origin. Although the evidence obtained from inflammatory pain animal
models has shown the existence of analgesic synergy between diclofenac and the B vitamins
mixture, the corresponding clinical evidence is scarce. A double-blind, randomized
clinical trial study was designed to characterize the analgesic effect and safety
of diclofenac and B vitamins against diclofenac alone in patients with severe osteoarthritis.
Forty eight patients programmed to total knee arthroplasty with a pain level ≥7 in
a 1–10 cm visual analogue scale were allocated to receive a single intramuscular injection
of sodium diclofenac (75 mg) alone or combined with thiamine (100 mg), pyridoxine
(100 mg) and cyanocobalamin (5 mg), and the pain level was evaluated during 12 h post-injection.
Diclofenac+B vitamins mixture showed a superior analgesic effect during the assessed
period and also a better assessment of the pain relief perception by patients than
diclofenac alone. This study constitutes a clinical support on the improvement of
the analgesic effect of diclofenac by B vitamins in patients with osteoarthritis programmed
to total knee arthroplasty, as a clinical model of inflammatory pain.
Key words
analgesia - osteoarthritis - B vitamins - diclofenac - inflammatory pain
