{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:52:11Z","timestamp":1779918731615,"version":"3.53.1"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"3-4","license":[{"start":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T00:00:00Z","timestamp":1672185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T00:00:00Z","timestamp":1672185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fresenius Kabi Austria Gmbh"},{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Wien Klin Wochenschr"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Postoperative intravenous diclofenac reduces patient opioid demand and is commonly used in surgical units. Orphenadrine is mainly used in combination with diclofenac for musculoskeletal injuries and postoperative pain control. The objective of this study was to compare the analgesic efficacy of diclofenac-orphenadrine, diclofenac alone and saline.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We performed a\u00a0double-blind, randomized, placebo-controlled, parallel-group, single-center clinical study investigating the opioid-sparing effect of a\u00a0combination of diclofenac and orphenadrine versus diclofenac alone versus isotonic saline solution. Initially 72\u00a0patients were included and received total intravenous anesthesia during cruciate ligament surgery. All patients were postoperatively treated with a\u00a0patient-controlled analgesia (PCA) device containing hydromorphone. Pharmacological safety was assessed by laboratory parameters, vital signs, and delirium detection scores.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There was no significant difference between the groups in cumulative dose of PCA analgesics required after 24\u202fh postsurgery, with 5.90\u202fmg (SD\u202f\u00b1\u20092.90\u202fmg) in the placebo group, 5.73\u202fmg (SD\u202f\u00b1\u20094.75\u202fmg) in the diclofenac group, and 4.13\u202fmg (SD\u202f\u00b1\u20092.57\u202fmg) in the diclofenac-orphenadrine group. Furthermore, there was no significant difference between the groups in cumulative dose of PCA analgesics required 2\u202fh postsurgery (<jats:italic>n<\/jats:italic>\u202f=\u200965). Mean dose of hydromorphone required after 2\u202fh was 1.54\u202fmg (SD\u202f\u00b1\u20090.57\u202fmg) in the placebo group, 1.56\u202fmg (SD\u202f\u00b1\u20091.19\u202fmg) in the diclofenac-only group, and 1.37\u202fmg (SD\u202f\u00b1\u20090.78\u202fmg) in the diclofenac-orphenadrine group. However, when comparing the diclofenac-orphenadrine group and the diclofenac group combined to placebo there was a\u00a0significant reduction in PCA usage in the first 24\u202fh postsurgery. In total, there were 25\u00a0adverse events reported, none of which were rated as severe.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Orphenadrine-diclofenac failed to significantly reduce postoperative opioid requirements. However, in an exploratory post hoc analysis the diclofenac-orphenadrine and the diclofenac group combined versus placebo showed a\u00a0tendency to reduce opioid demand in postoperative pain control. Further research is required to determine the value of orphenadrine as an adjuvant in a\u00a0multimodal approach for postoperative pain management.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00508-022-02131-x","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T12:04:06Z","timestamp":1672229046000},"page":"67-74","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Intravenous diclofenac and orphenadrine for the treatment of postoperative pain after remifentanil-based anesthesia"],"prefix":"10.1007","volume":"135","author":[{"given":"Sebastian","family":"Zeiner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Haider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Zotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Th\u00fcringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"H\u00f6bart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9766-1360","authenticated-orcid":false,"given":"Oliver","family":"Kimberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Knolle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,28]]},"reference":[{"issue":"2","key":"2131_CR1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.bpa.2014.03.005","volume":"28","author":"GP Joshi","year":"2014","unstructured":"Joshi\u00a0GP, Schug\u00a0SA, Kehlet\u00a0H. 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