The effect of chlorzoxazone on acute pain after spine surgery: A randomized, blinded trial

R V Nielsen; J S Fomsgaard; M H Siegel; R Martusevicius; O Mathiesen; J B Dahl

doi:10.1111/aas.12754

The effect of chlorzoxazone on acute pain after spine surgery: A randomized, blinded trial

R V Nielsen, J S Fomsgaard, M H Siegel, R Martusevicius, O Mathiesen, J B Dahl

Department of Clinical Medicine

5 Citations (Scopus)

Abstract

BACKGROUND: Chlorzoxazone is a muscle relaxant administered for musculoskeletal pain, and as an analgesic adjunct for post-operative pain. Chlorzoxazone for low back pain is currently not advised due to the lack of placebo-controlled trials. We explored the effect of chlorzoxazone on acute pain after spine surgery.

METHODS: One hundred and ten patients were randomly assigned to 500 mg oral chlorzoxazone or placebo in this blinded study of patients having spine surgery under general anaesthesia. In the 4 h trial period analgesia consisted of IV patient-controlled analgesia (morphine bolus 2.5 mg). Primary outcome was pain during mobilization (visual analogue scale) 2 h after the intervention. Secondary outcomes were pain at rest, opioid consumption, nausea, vomiting, sedation and dizziness.

RESULTS: For pain during mobilization 2 h after intervention, there was no significant difference between groups: 51 (21) vs. 54 (25) mm in the chlorzoxazone and placebo groups, respectively, mean difference 3 mm (95% CI -8 to 10), P = 0.59. For pain during mobilization and at rest (wAUC 1-4 h), there were no significant differences between groups. There was no significant difference in total IV morphine use 0-4 h: median 10 (7-21) vs. 13 (5-19) mg in the chlorzoxazone and placebo groups, respectively, P = 0.82. We found no significant difference in adverse effects.

CONCLUSION: No analgesic effect of single-dose chlorzoxazone was demonstrated in patients with acute pain after spine surgery. Based on these findings, chlorzoxazone cannot be recommended for immediate treatment of acute pain after such procedures.

Original language	English
Journal	Acta Anaesthesiologica Scandinavica
Volume	60
Issue number	8
Pages (from-to)	1152-60
Number of pages	9
ISSN	0001-5172
DOIs	https://doi.org/10.1111/aas.12754
Publication status	Published - 1 Sept 2016

Keywords

Acute Pain
Adult
Aged
Analgesia, Patient-Controlled
Chlorzoxazone
Female
Humans
Male
Middle Aged
Muscle Relaxants, Central
Pain, Postoperative
Prospective Studies
Spine
Journal Article
Randomized Controlled Trial

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10.1111/aas.12754

Cite this

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title = "The effect of chlorzoxazone on acute pain after spine surgery: A randomized, blinded trial",

abstract = "BACKGROUND: Chlorzoxazone is a muscle relaxant administered for musculoskeletal pain, and as an analgesic adjunct for post-operative pain. Chlorzoxazone for low back pain is currently not advised due to the lack of placebo-controlled trials. We explored the effect of chlorzoxazone on acute pain after spine surgery.METHODS: One hundred and ten patients were randomly assigned to 500 mg oral chlorzoxazone or placebo in this blinded study of patients having spine surgery under general anaesthesia. In the 4 h trial period analgesia consisted of IV patient-controlled analgesia (morphine bolus 2.5 mg). Primary outcome was pain during mobilization (visual analogue scale) 2 h after the intervention. Secondary outcomes were pain at rest, opioid consumption, nausea, vomiting, sedation and dizziness.RESULTS: For pain during mobilization 2 h after intervention, there was no significant difference between groups: 51 (21) vs. 54 (25) mm in the chlorzoxazone and placebo groups, respectively, mean difference 3 mm (95% CI -8 to 10), P = 0.59. For pain during mobilization and at rest (wAUC 1-4 h), there were no significant differences between groups. There was no significant difference in total IV morphine use 0-4 h: median 10 (7-21) vs. 13 (5-19) mg in the chlorzoxazone and placebo groups, respectively, P = 0.82. We found no significant difference in adverse effects.CONCLUSION: No analgesic effect of single-dose chlorzoxazone was demonstrated in patients with acute pain after spine surgery. Based on these findings, chlorzoxazone cannot be recommended for immediate treatment of acute pain after such procedures.",

keywords = "Acute Pain, Adult, Aged, Analgesia, Patient-Controlled, Chlorzoxazone, Female, Humans, Male, Middle Aged, Muscle Relaxants, Central, Pain, Postoperative, Prospective Studies, Spine, Journal Article, Randomized Controlled Trial",

author = "Nielsen, {R V} and Fomsgaard, {J S} and Siegel, {M H} and R Martusevicius and O Mathiesen and Dahl, {J B}",

note = "{\textcopyright} 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",

year = "2016",

month = sep,

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doi = "10.1111/aas.12754",

language = "English",

volume = "60",

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journal = "Acta Anaesthesiologica Scandinavica",

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TY - JOUR

T1 - The effect of chlorzoxazone on acute pain after spine surgery

T2 - A randomized, blinded trial

AU - Nielsen, R V

AU - Fomsgaard, J S

AU - Siegel, M H

AU - Martusevicius, R

AU - Mathiesen, O

AU - Dahl, J B

PY - 2016/9/1

Y1 - 2016/9/1

N2 - BACKGROUND: Chlorzoxazone is a muscle relaxant administered for musculoskeletal pain, and as an analgesic adjunct for post-operative pain. Chlorzoxazone for low back pain is currently not advised due to the lack of placebo-controlled trials. We explored the effect of chlorzoxazone on acute pain after spine surgery.METHODS: One hundred and ten patients were randomly assigned to 500 mg oral chlorzoxazone or placebo in this blinded study of patients having spine surgery under general anaesthesia. In the 4 h trial period analgesia consisted of IV patient-controlled analgesia (morphine bolus 2.5 mg). Primary outcome was pain during mobilization (visual analogue scale) 2 h after the intervention. Secondary outcomes were pain at rest, opioid consumption, nausea, vomiting, sedation and dizziness.RESULTS: For pain during mobilization 2 h after intervention, there was no significant difference between groups: 51 (21) vs. 54 (25) mm in the chlorzoxazone and placebo groups, respectively, mean difference 3 mm (95% CI -8 to 10), P = 0.59. For pain during mobilization and at rest (wAUC 1-4 h), there were no significant differences between groups. There was no significant difference in total IV morphine use 0-4 h: median 10 (7-21) vs. 13 (5-19) mg in the chlorzoxazone and placebo groups, respectively, P = 0.82. We found no significant difference in adverse effects.CONCLUSION: No analgesic effect of single-dose chlorzoxazone was demonstrated in patients with acute pain after spine surgery. Based on these findings, chlorzoxazone cannot be recommended for immediate treatment of acute pain after such procedures.

AB - BACKGROUND: Chlorzoxazone is a muscle relaxant administered for musculoskeletal pain, and as an analgesic adjunct for post-operative pain. Chlorzoxazone for low back pain is currently not advised due to the lack of placebo-controlled trials. We explored the effect of chlorzoxazone on acute pain after spine surgery.METHODS: One hundred and ten patients were randomly assigned to 500 mg oral chlorzoxazone or placebo in this blinded study of patients having spine surgery under general anaesthesia. In the 4 h trial period analgesia consisted of IV patient-controlled analgesia (morphine bolus 2.5 mg). Primary outcome was pain during mobilization (visual analogue scale) 2 h after the intervention. Secondary outcomes were pain at rest, opioid consumption, nausea, vomiting, sedation and dizziness.RESULTS: For pain during mobilization 2 h after intervention, there was no significant difference between groups: 51 (21) vs. 54 (25) mm in the chlorzoxazone and placebo groups, respectively, mean difference 3 mm (95% CI -8 to 10), P = 0.59. For pain during mobilization and at rest (wAUC 1-4 h), there were no significant differences between groups. There was no significant difference in total IV morphine use 0-4 h: median 10 (7-21) vs. 13 (5-19) mg in the chlorzoxazone and placebo groups, respectively, P = 0.82. We found no significant difference in adverse effects.CONCLUSION: No analgesic effect of single-dose chlorzoxazone was demonstrated in patients with acute pain after spine surgery. Based on these findings, chlorzoxazone cannot be recommended for immediate treatment of acute pain after such procedures.

KW - Acute Pain

KW - Adult

KW - Aged

KW - Analgesia, Patient-Controlled

KW - Chlorzoxazone

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Muscle Relaxants, Central

KW - Pain, Postoperative

KW - Prospective Studies

KW - Spine

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.1111/aas.12754

DO - 10.1111/aas.12754

M3 - Journal article

C2 - 27306492

SN - 0001-5172

VL - 60

SP - 1152

EP - 1160

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 8

ER -

The effect of chlorzoxazone on acute pain after spine surgery: A randomized, blinded trial

Abstract

Keywords

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