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Локальное применение нестероидных противовоспалительных препаратов у пациентов с дорсопатией
Локальное применение нестероидных противовоспалительных препаратов у пациентов с дорсопатией
Камчатнов П.Р., Чугунов А.В., Шурыгин С.Н. Локальное применение нестероидных противовоспалительных препаратов у пациентов с дорсопатией. Consilium Medicum. 2019; 21 (2): 90–94. DOI: 10.26442/20751753.2019.2.190313
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Аннотация
Дорсопатия (ДП) – широко распространенный скелетно-мышечный болевой синдром. Основным направлением лечения пациентов с ДП является назначение нестероидных противовоспалительных препаратов (НПВП) с учетом их обезболивающего и противовоспалительного эффектов. Вследствие того, что многие пациенты с ДП имеют ряд сопутствующих соматических заболеваний, нуждаются в систематическом приеме лекарственных препаратов, лечебная тактика должна строиться с учетом риска развития нежелательных побочных эффектов и лекарственных взаимодействий. Соблюдению баланса между эффективностью лечения и его безопасностью у пациентов с ДП способствует применение трансдермальных форм НПВП, в частности, препарата Вольтарен® Эмульгель® 2%. Рассмотрены данные 31 научного источника, опубликованные в российской и зарубежной печати в период 2008–2019 гг., представляющие современные сведения о применения такого рода лечения, его достоинствах и ограничениях, подтвержденные результатами исследований, которые посвящены биодоступности препаратов, их эффективности и переносимости. Назначение трансдермальных форм НПВП (гель, крем, пластырь) оказывается значительно безопаснее других форм введения препарата, что делает обоснованным его использование у пациентов с сопутствующими заболеваниями почек, печени, высоким кардиоваскулярным и гастроинтестинальным рисками. Применение Вольтарен® Эмульгель® 2% у больных с ДП позволяет сократить сроки лечения при умеренно выраженном болевым синдроме и уменьшить потребность в дополнительном приеме НПВП и анальгетиков.
Ключевые слова: дорсопатия, нестероидные противовоспалительные препараты, трансдермальные лекарственные формы, Вольтарен, диклофенак, Вольтарен Эмульгель, терапия.
Ключевые слова: дорсопатия, нестероидные противовоспалительные препараты, трансдермальные лекарственные формы, Вольтарен, диклофенак, Вольтарен Эмульгель, терапия.
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Dorsopathy (DP) is a frequent musculoskeletal pain syndrome. The main approach to treatment of patients with DP is the use of non-steroid anti-inflammatory drugs (NSAIDs) with account of their analgesic and anti-inflammatory effects. Considering that many patients with DP have a variety of comorbid conditions and need to use medications systematically, risk of adverse effects development and possible drug interactions should be considered in treatment tactics. The use of transdermal NSAIDs delivery systems, in particular Voltaren® Emulgel® 2% , contributes to maintaimance of the balance of treatment effectiveness and safety. Data from 31 scientific sources published in Russia and abroad during years 2008–2019 that present modern view on the use of such treatment, its advantages and disadvantages confirmed with the results of studies of medications bioavailability, effectiveness and safety are reviewed. The use of transdermal NSAIDs delivery systems (gel, cream, plaster) is considered much safer than the use of other drug delivery methods that makes reasonable to use them in patients with concurrent kidney or liver diseases, and in patients with high cardiovascular and gastrointestinal risks. Voltaren® Emulgel® 2% use in patients with DP allows to reduce treatment duration in patients with moderate pain syndrome and to reduce the need for additional NSAIDs and analgesics use.
Key words: dorsopathy, non-steroid anti-inflammatory drugs, transdermal drug delivery system, Voltaren, diclofenac, Voltaren Emulgel, therapy.
Key words: dorsopathy, non-steroid anti-inflammatory drugs, transdermal drug delivery system, Voltaren, diclofenac, Voltaren Emulgel, therapy.
Полный текст
Список литературы
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[Parfenov V.A., Iakhno N.N., Kukushkin M.L. et al. Ostraia nespetsificheskaia (skeletno-myshechnaia) poiasnichnaia bol'. Rekomendatsii Rossiiskogo obshchestva po izucheniiu boli (ROIB). Nevrologiia, neiropsikhiatriia, psikhosomatika. 2018; 10 (2): 4–11 (in Russian).]
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[Barantsevich E.R., Andreev V. Vozmozhnosti lecheniia khronicheskoi boli pri poiasnichno-kresttsovoi radikulopatii. Vrach. 2012; 11: 13–9 (in Russian).]
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[Barulin A.E., Kurushina O.V., Puchkov A.E. Kompleksnoe lechenie ostroi nespetsificheskoi boli v nizhnei chasti spiny. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2014; 6 (3): 38–42. DOI: 10.14412/2074-2711-2014-3-38-42 (in Russian).]
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[Esin R.G., Esin O.R., Akhmadeeva G.D., Salikhova G.V. Bol' v spine. Kazan': Kazanskii poligrafkombinat, 2010 (in Russian).]
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[Kamchatnov P.R. Povyshenie effektivnosti i bezopasnosti lecheniia patsientov s poiasnichnoi bol'iu. Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2016; 116 (10): 28–33. DOI: 10.17116/jnevro201611610128-33 (in Russian).]
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19. Yang M, Wang H-T, Zhao M et al. Network Meta-Analysis Comparing Relatively Selective COX-2 Inhibitors Versus Coxibs for the Prevention of NSAID-Induced Gastrointestinal Injury. Medicine (Baltimore) 2015; 94 (40): P15–12576. DOI: 10.1097/MD.0000000000001592
20. Nissen S, Yeomans N, Solomon D et al. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med 2016; 375 (26): 2519–29. DOI: 10.1056/NEJMoa1611593
21. Arfе A, Scotti L, Varas-Lorenzo C et al. Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. BMJ 2016; 354: i4857. http: //dx.doi.org/10.1136/bmj.i4857
22. Moore N, Pollack C, Butkerait P. Adverse drug reactions and drug–drug interactions with over-the-counter NSAIDs. Ther Clin Risk Manag 2015; 11: 1061–75. DOI: 10.2147/TCRM.S79135
23. Trimble J, Light B. Effect of Penetration Enhancers on the Percutaneous Delivery of Pain Management Actives. Int J Pharm Compd 2016; 20 (3): 250–6.
24. Altman R, Barkin R. Topical therapy for osteoarthritis: clinical and pharmacologic perspectives. Postgrad Med 2009; 121 (2): 139–47.
25. Rother M, Conaghan P. A randomized, double-blind, phase III trial in moderate osteoarthritis knee pain comparing topical ketoprofen gel with ketoprofen-free gel. J Rheumatol 2013; 40 (10): 1742–8. DOI: 10.3899/jrheum.130192
26. Rodriguez-Merchan E. Topical therapies for knee osteoarthritis. Postgrad Med 2018; 130 (7): 607–12. DOI: 10.1080/00325481.2018.1505182
27. Derry S, Wiffen P, Kalso et al. Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017; 5: CD008609. DOI: 10.1002/14651858.CD008609.pub2
28. Derry S, Conaghan P, Da Silva J. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev 2016; 4: CD007400. DOI: 10.1002/14651858.CD007400.pub3
29. Bussin E, Cairns B, Bovard J, Scott A. Randomised controlled trial evaluating the short-term analgesic effect of topical diclofenac on chronic Achilles tendon pain: a pilot study. BMJ Open. 2017; 7 (4): e015126. DOI: 10.1136/bmjopen-2016-015126
30. Babaieasl F, Yarandi H, Saeidzadeh S, Kheradmand M. Comparison of EMLA and Diclofenac on Reduction of Pain and Phlebitis Caused by Peripheral IV Catheter: A Randomized-Controlled Trial Study. Home Healthc Now 2019; 37 (1): 17–22. DOI: 10.1097/NHH.0000000000000704
31. McCarberg B, D'Arcy Y. Options in topical therapies in the management of patients with acute pain. Postgrad Med 2013; 125 (4 Suppl. 1): 19–24. DOI: 10.1080/00325481.2013.1110567011
2. Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J 2008; 8 (1): 8–20.
3. Sivasubramaniam V, Patel H, Ozdemir B et al. Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time series study. BMJ Open 2015; 5: e009011. DOI: 10.1136/bmjopen-2015-009011
4. Montgomery W, Sato M, Nagasaka Y, Vietri J. The economic and humanistic costs of chronic lower back pain in Japan. Clin Econom Outcom Res 2017: 9 361–71.
5. Sadosky A, DiBonaventura M, Cappelleri J et al. The association between lower back pain and health status, work productivity, and health care resource use in Japan. J Pain Res 2015; 8: 119–30.
6. Vos T, Flaxman A, Naghavi M et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2163–96.
7. Parfenov V.A., Iakhno N.N., Kukushkin M.L. et al. Ostraia nespetsificheskaia (skeletno-myshechnaia) poiasnichnaia bol'. Rekomendatsii Rossiiskogo obshchestva po izucheniiu boli (ROIB). Nevrologiia, neiropsikhiatriia, psikhosomatika. 2018; 10 (2): 4–11 (in Russian).
8. Wong J, Cote P, Sutton D et al. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain 2017; 21 (2): 201–16. DOI: 10.1002/ejp.931
9. Barantsevich E.R., Andreev V. Vozmozhnosti lecheniia khronicheskoi boli pri poiasnichno-kresttsovoi radikulopatii. Vrach. 2012; 11: 13–9 (in Russian).
10. Barulin A.E., Kurushina O.V., Puchkov A.E. Kompleksnoe lechenie ostroi nespetsificheskoi boli v nizhnei chasti spiny. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2014; 6 (3): 38–42. DOI: 10.14412/2074-2711-2014-3-38-42 (in Russian).
11. Cherkin DC, Herman PM. Cognitive and Mind-Body Therapies for Chronic Low Back Pain and Neck Pain Effectiveness and Value. JAMA Intern Med 2018; 178 (4): 556–7. DOI: 10.1001/jamainternmed.2018.0113
12. Esin R.G., Esin O.R., Akhmadeeva G.D., Salikhova G.V. Bol' v spine. Kazan': Kazanskii poligrafkombinat, 2010 (in Russian).
13. Kamchatnov P.R. Povyshenie effektivnosti i bezopasnosti lecheniia patsientov s poiasnichnoi bol'iu. Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2016; 116 (10): 28–33. DOI: 10.17116/jnevro201611610128-33 (in Russian).
14. Chou R, Qaseem A, Snow V et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med 2007; 147: 478–91.
15. Roberts E, Nunes V, Buckner S et al. Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Ann Rheum Dis 2016; 75: 552–9. DOI: 10.1136/annrheumdis-2014-206914
16. Saragiotto B, Machado G, Ferreira M et al. Paracetamol for low back pain. Cochrane Database Syst Rev 2016; 6: CD012230. DOI: 10.1002/14651858.CD012230
17. Kötter T, da Costa B, Fässler M et al. Metamizole-Associated Adverse Events: A Systematic Review and Meta-Analysis. PLoS ONE 2015; 10 (4): e0122918. DOI: 10.1371/journal.pone.0122918
18. Jiménez-Ávila JM, Rubio-Flores EN, González-Cisneros A et al. Guidelines on the application of the clinical practice guideline on low back pain. Cir Cir 2019; 86 (1): 24–32. DOI: 10.24875/CIRUE.M18000004
19. Yang M, Wang H-T, Zhao M et al. Network Meta-Analysis Comparing Relatively Selective COX-2 Inhibitors Versus Coxibs for the Prevention of NSAID-Induced Gastrointestinal Injury. Medicine (Baltimore) 2015; 94 (40): P15–12576. DOI: 10.1097/MD.0000000000001592
20. Nissen S, Yeomans N, Solomon D et al. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med 2016; 375 (26): 2519–29. DOI: 10.1056/NEJMoa1611593
21. Arfе A, Scotti L, Varas-Lorenzo C et al. Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. BMJ 2016; 354: i4857. http: //dx.doi.org/10.1136/bmj.i4857
22. Moore N, Pollack C, Butkerait P. Adverse drug reactions and drug–drug interactions with over-the-counter NSAIDs. Ther Clin Risk Manag 2015; 11: 1061–75. DOI: 10.2147/TCRM.S79135
23. Trimble J, Light B. Effect of Penetration Enhancers on the Percutaneous Delivery of Pain Management Actives. Int J Pharm Compd 2016; 20 (3): 250–6.
24. Altman R, Barkin R. Topical therapy for osteoarthritis: clinical and pharmacologic perspectives. Postgrad Med 2009; 121 (2): 139–47.
25. Rother M, Conaghan P. A randomized, double-blind, phase III trial in moderate osteoarthritis knee pain comparing topical ketoprofen gel with ketoprofen-free gel. J Rheumatol 2013; 40 (10): 1742–8. DOI: 10.3899/jrheum.130192
26. Rodriguez-Merchan E. Topical therapies for knee osteoarthritis. Postgrad Med 2018; 130 (7): 607–12. DOI: 10.1080/00325481.2018.1505182
27. Derry S, Wiffen P, Kalso et al. Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017; 5: CD008609. DOI: 10.1002/14651858.CD008609.pub2
28. Derry S, Conaghan P, Da Silva J. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev 2016; 4: CD007400. DOI: 10.1002/14651858.CD007400.pub3
29. Bussin E, Cairns B, Bovard J, Scott A. Randomised controlled trial evaluating the short-term analgesic effect of topical diclofenac on chronic Achilles tendon pain: a pilot study. BMJ Open. 2017; 7 (4): e015126. DOI: 10.1136/bmjopen-2016-015126
30. Babaieasl F, Yarandi H, Saeidzadeh S, Kheradmand M. Comparison of EMLA and Diclofenac on Reduction of Pain and Phlebitis Caused by Peripheral IV Catheter: A Randomized-Controlled Trial Study. Home Healthc Now 2019; 37 (1): 17–22. DOI: 10.1097/NHH.0000000000000704
31. McCarberg B, D'Arcy Y. Options in topical therapies in the management of patients with acute pain. Postgrad Med 2013; 125 (4 Suppl. 1): 19–24. DOI: 10.1080/00325481.2013.1110567011
2. Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J 2008; 8 (1): 8–20.
3. Sivasubramaniam V, Patel H, Ozdemir B et al. Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time series study. BMJ Open 2015; 5: e009011. DOI: 10.1136/bmjopen-2015-009011
4. Montgomery W, Sato M, Nagasaka Y, Vietri J. The economic and humanistic costs of chronic lower back pain in Japan. Clin Econom Outcom Res 2017: 9 361–71.
5. Sadosky A, DiBonaventura M, Cappelleri J et al. The association between lower back pain and health status, work productivity, and health care resource use in Japan. J Pain Res 2015; 8: 119–30.
6. Vos T, Flaxman A, Naghavi M et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2163–96.
7. Парфенов В.А., Яхно Н.Н., Кукушкин М.Л. и др. Острая неспецифическая (скелетно-мышечная) поясничная боль. Рекомендации Российского общества по изучению боли (РОИБ). Неврология, нейропсихиатрия, психосоматика. 2018; 10 (2): 4–11.
[Parfenov V.A., Iakhno N.N., Kukushkin M.L. et al. Ostraia nespetsificheskaia (skeletno-myshechnaia) poiasnichnaia bol'. Rekomendatsii Rossiiskogo obshchestva po izucheniiu boli (ROIB). Nevrologiia, neiropsikhiatriia, psikhosomatika. 2018; 10 (2): 4–11 (in Russian).]
8. Wong J, Cote P, Sutton D et al. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain 2017; 21 (2): 201–16. DOI: 10.1002/ejp.931
9. Баранцевич Е.Р., Андреев В. Возможности лечения хронической боли при пояснично-крестцовой радикулопатии. Врач. 2012; 11: 13–9.
[Barantsevich E.R., Andreev V. Vozmozhnosti lecheniia khronicheskoi boli pri poiasnichno-kresttsovoi radikulopatii. Vrach. 2012; 11: 13–9 (in Russian).]
10. Барулин А.Е., Курушина О.В., Пучков А.Е. Комплексное лечение острой неспецифической боли в нижней части спины. Неврология, нейропсихиатрия, психосоматика. 2014; 6 (3): 38–42. DOI: 10.14412/2074-2711-2014-3-38-42
[Barulin A.E., Kurushina O.V., Puchkov A.E. Kompleksnoe lechenie ostroi nespetsificheskoi boli v nizhnei chasti spiny. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2014; 6 (3): 38–42. DOI: 10.14412/2074-2711-2014-3-38-42 (in Russian).]
11. Cherkin DC, Herman PM. Cognitive and Mind-Body Therapies for Chronic Low Back Pain and Neck Pain Effectiveness and Value. JAMA Intern Med 2018; 178 (4): 556–7. DOI: 10.1001/jamainternmed.2018.0113
12. Есин Р.Г., Есин О.Р., Ахмадеева Г.Д., Салихова Г.В. Боль в спине. Казань: Казанский полиграфкомбинат, 2010.
[Esin R.G., Esin O.R., Akhmadeeva G.D., Salikhova G.V. Bol' v spine. Kazan': Kazanskii poligrafkombinat, 2010 (in Russian).]
13. Камчатнов П.Р. Повышение эффективности и безопасности лечения пациентов с поясничной болью. Журнал неврологии и психиатрии им. С.С.Корсакова. 2016; 116 (10): 28–33. DOI: 10.17116/jnevro201611610128-33
[Kamchatnov P.R. Povyshenie effektivnosti i bezopasnosti lecheniia patsientov s poiasnichnoi bol'iu. Zhurnal nevrologii i psikhiatrii im. S.S.Korsakova. 2016; 116 (10): 28–33. DOI: 10.17116/jnevro201611610128-33 (in Russian).]
14. Chou R, Qaseem A, Snow V et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med 2007; 147: 478–91.
15. Roberts E, Nunes V, Buckner S et al. Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Ann Rheum Dis 2016; 75: 552–9. DOI: 10.1136/annrheumdis-2014-206914
16. Saragiotto B, Machado G, Ferreira M et al. Paracetamol for low back pain. Cochrane Database Syst Rev 2016; 6: CD012230. DOI: 10.1002/14651858.CD012230
17. Kötter T, da Costa B, Fässler M et al. Metamizole-Associated Adverse Events: A Systematic Review and Meta-Analysis. PLoS ONE 2015; 10 (4): e0122918. DOI: 10.1371/journal.pone.0122918
18. Jiménez-Ávila JM, Rubio-Flores EN, González-Cisneros A et al. Guidelines on the application of the clinical practice guideline on low back pain. Cir Cir 2019; 86 (1): 24–32. DOI: 10.24875/CIRUE.M18000004
19. Yang M, Wang H-T, Zhao M et al. Network Meta-Analysis Comparing Relatively Selective COX-2 Inhibitors Versus Coxibs for the Prevention of NSAID-Induced Gastrointestinal Injury. Medicine (Baltimore) 2015; 94 (40): P15–12576. DOI: 10.1097/MD.0000000000001592
20. Nissen S, Yeomans N, Solomon D et al. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med 2016; 375 (26): 2519–29. DOI: 10.1056/NEJMoa1611593
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26. Rodriguez-Merchan E. Topical therapies for knee osteoarthritis. Postgrad Med 2018; 130 (7): 607–12. DOI: 10.1080/00325481.2018.1505182
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29. Bussin E, Cairns B, Bovard J, Scott A. Randomised controlled trial evaluating the short-term analgesic effect of topical diclofenac on chronic Achilles tendon pain: a pilot study. BMJ Open. 2017; 7 (4): e015126. DOI: 10.1136/bmjopen-2016-015126
30. Babaieasl F, Yarandi H, Saeidzadeh S, Kheradmand M. Comparison of EMLA and Diclofenac on Reduction of Pain and Phlebitis Caused by Peripheral IV Catheter: A Randomized-Controlled Trial Study. Home Healthc Now 2019; 37 (1): 17–22. DOI: 10.1097/NHH.0000000000000704
31. McCarberg B, D'Arcy Y. Options in topical therapies in the management of patients with acute pain. Postgrad Med 2013; 125 (4 Suppl. 1): 19–24. DOI: 10.1080/00325481.2013.1110567011
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20. Nissen S, Yeomans N, Solomon D et al. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med 2016; 375 (26): 2519–29. DOI: 10.1056/NEJMoa1611593
21. Arfе A, Scotti L, Varas-Lorenzo C et al. Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. BMJ 2016; 354: i4857. http: //dx.doi.org/10.1136/bmj.i4857
22. Moore N, Pollack C, Butkerait P. Adverse drug reactions and drug–drug interactions with over-the-counter NSAIDs. Ther Clin Risk Manag 2015; 11: 1061–75. DOI: 10.2147/TCRM.S79135
23. Trimble J, Light B. Effect of Penetration Enhancers on the Percutaneous Delivery of Pain Management Actives. Int J Pharm Compd 2016; 20 (3): 250–6.
24. Altman R, Barkin R. Topical therapy for osteoarthritis: clinical and pharmacologic perspectives. Postgrad Med 2009; 121 (2): 139–47.
25. Rother M, Conaghan P. A randomized, double-blind, phase III trial in moderate osteoarthritis knee pain comparing topical ketoprofen gel with ketoprofen-free gel. J Rheumatol 2013; 40 (10): 1742–8. DOI: 10.3899/jrheum.130192
26. Rodriguez-Merchan E. Topical therapies for knee osteoarthritis. Postgrad Med 2018; 130 (7): 607–12. DOI: 10.1080/00325481.2018.1505182
27. Derry S, Wiffen P, Kalso et al. Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017; 5: CD008609. DOI: 10.1002/14651858.CD008609.pub2
28. Derry S, Conaghan P, Da Silva J. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev 2016; 4: CD007400. DOI: 10.1002/14651858.CD007400.pub3
29. Bussin E, Cairns B, Bovard J, Scott A. Randomised controlled trial evaluating the short-term analgesic effect of topical diclofenac on chronic Achilles tendon pain: a pilot study. BMJ Open. 2017; 7 (4): e015126. DOI: 10.1136/bmjopen-2016-015126
30. Babaieasl F, Yarandi H, Saeidzadeh S, Kheradmand M. Comparison of EMLA and Diclofenac on Reduction of Pain and Phlebitis Caused by Peripheral IV Catheter: A Randomized-Controlled Trial Study. Home Healthc Now 2019; 37 (1): 17–22. DOI: 10.1097/NHH.0000000000000704
31. McCarberg B, D'Arcy Y. Options in topical therapies in the management of patients with acute pain. Postgrad Med 2013; 125 (4 Suppl. 1): 19–24. DOI: 10.1080/00325481.2013.1110567011
Авторы
П.Р.Камчатнов*1, А.В.Чугунов1, С.Н.Шурыгин2
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России, Москва, Россия;
2 ГБУЗ «Городская клиническая больница им. В.М.Буянова» Департамента здравоохранения г. Москвы, Москва, Россия
*pavkam7@gmail.com
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России, Москва, Россия;
2 ГБУЗ «Городская клиническая больница им. В.М.Буянова» Департамента здравоохранения г. Москвы, Москва, Россия
*pavkam7@gmail.com
________________________________________________
Pavel R. Kamchatnov*1, Aleksandr V. Chugunov1, Sergei N. Shurygin2
1 Pirogov Russian National Research Medical University, Moscow, Russia;
1 Pirogov Russian National Research Medical University, Moscow, Russia;
2 V.M.Buyanov Moscow City Clinical Hospital, Moscow, Russia
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