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To evaluate whether a diclofenac epolamine + heparin topical (plaster) is more effective than diclofenac plaster alone in reducing deep somatic hyperalgesia in subjects without spontaneous pain and whether the effect is linked to or independent of the anti-edematous action of heparin.
Benefits for
Diclofenac Plus Heparin (plaster treatment especially on the thigh) was drawn
from this original article as compared to diclofenac alone. This treatment
provides a rational outcome for the Algogenic condition of the lower limb.
To evaluate
whether a diclofenac epolamine + heparin topical (plaster) is more effective
than diclofenac plaster alone in reducing deep somatic hyperalgesia in subjects
without spontaneous pain and whether the effect is linked to or independent of
the anti-edematous action of heparin.
Prospective,
double-blind, randomized and controlled, four-arm parallel design trial. One
hundred and four patients (84 women, 20 men, mean age 42.2 ± 13.3 years), with
deep somatic hyperalgesia in one thigh, randomly assigned to one of 4 groups of
26 each.
Each group
underwent one of the following plaster treatments on one thigh:
diclofenac+heparin; diclofenac; heparin; placebo, for 7 days, renewing the
plaster every 24 hours. Before treatment (day 1), at day 4 and day 8,
assessment of (a) pressure and electrical pain thresholds of vastus lateralis
and overlying subcutis and skin; and (b) structure/thickness of subcutis and
muscle with ultrasounds at the same level.
During treatment,
in placebo and heparin, no significant threshold changes, except subcutis
thresholds which increased slightly (P < 0.02); in diclofenac and
diclofenac+heparin, significant increase in all thresholds (0.0001 < P <
0.04). Electrical muscle pain thresholds increased significantly more in
diclofenac+heparin than in diclofenac, heparin, and placebo (0.0001 < P <
0.04). In all groups: no edema and thickness changes at ultrasounds in muscle
and subcutis.
Topical
diclofenac+heparin is significantly more effective than diclofenac alone in
reducing muscle hyperalgesia in subjects without spontaneous pain,
independently of the anti-edematous action of heparin. The results provide a
rationale for the use of diclofenac+heparin also in algogenic conditions
without evident signs of injury/edema/hematoma.
Pain practise
Effects of Topical Diclofenac Plus Heparin (Dhep+H Plaster) on Somatic Pain Sensitivity in Healthy Subjects With a Latent Algogenic Condition of the Lower Limb
Giannapia Affaitati et al.
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