Comparison Study Shows 3 Analgesic Treatments Equally Effective After Endoscopic Urology Surgery

Pipemidic acid, phenazopyridine HCl, and sodium diclofenac are effective for pain relief following endoscopic urology surgery without side effects, and it is safe when used in combination with antibiotics and anticoagulants, according to a study presented here at the 31st Annual European Association of Urology (EAU) Congress.

However, pipemidic acid showed a superior analgesic effect than phenazopyridine HCl and sodium diclofenac.

“The ideal postoperative analgesic treatment will provide rapid and effective pain relief for the patient, and a low incidence of adverse effects, minimal impact on organ systems, and no significant interactions with other pharmacological agents,” said Prahara Yuri, MD, Department of Urology, University of Indonesia, Jakarta, Indonesia, on March 13.

The current study randomised 80 patients who had undergone endoscopic urology surgery to receive placebo (n = 20), pipemidic acid 400 mg BID (n = 20), phenazopyridine HCl 200 mg TID (n = 20) or sodium diclofenac 50 mg BID (n = 20) for 4 days after surgery. All patients received antibiotics and anticoagulants.

Their pain perception was assessed from the first to the seventh day after surgery, according to a visual analogue scale (VAS). Over this time, compared with placebo, all of the study drugs showed significantly reduced VAS pain scores (P< .05).

A post-hoc analysis demonstrated that pipemidic acid showed significantly superior analgesic effects over all of the other treatment arms and across the whole investigation period (P< .05).

In the safety analysis, compared with placebo, overall there were fewer adverse events experienced under all of the active treatments, indicating no safety issues for them. The most frequent adverse events were nausea and abdominal discomfort.

[Presentation title: Effects of Pipemidic Acid, Phenazopyridine HCl and Sodium Diclofenac on Pain Perception After Endoscopic Urology Surgery: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Trial. Abstract 343]