The effectiveness of diclofenac diethylammonium in spray form on pain in patients admitted to the emergency department with acute ankle sprain

INTRODUCTION AND AIM: In this study, it was aimed to evaluate the efficacy of topical analgesic application on acute pain in patients who applied to the emergency department with ankle sprain at the first admission. METHODS: This prospective, cross-sectional and single-blind study was conducted between 1 May 2021 and 31 April 2023 in T.C. A total of 80 adult patients aged 18-65 years, who applied to the Ministry of Health Sakarya Training and Research Hospital Emergency Medicine Clinic due to acute unilateral ankle sprain, were divided into four groups according to the treatment approach. Within the scope of the study, demographic data of the patients, pain levels, duration of injury, presence of other injuries, comorbidities and ASA scores were recorded. In addition, the level of ankle sprain classification according to physical examination and radiography needs according to Ottawa ankle rules were recorded. RESULTS: The mean age of the participants included in the study was 31.9±12.3 years and 58.75% were male. In ankle sprains, it was determined that only menthol, three and six sprays of diclofenac diethylammonium + menthol spray application significantly reduced pain in the first 15 minutes compared to the placebo group (respectively; p<0.001, p<0.001, p<0.001). However, no statistically significant difference was found between menthol application alone and three sprays of diclofenac diethylammonium+menthol spray in the evaluations made at the 15th and 30th minutes (p=0.202, p=0.828). On the other hand, it was determined that six sprays of diclofenac diethylammonium + menthol spray applied to both menthol and three sprays of diclofenac diethylammonium + menthol spray statistically significantly reduced pain (respectively; p=0.003, p=0.003, p<0.001, p=0.001). ) CONCLUSION: Both menthol and diclofenac diethylammonium+menthol spray application is effective for early pain relief in ankle sprains. The most effective application method is the application of diclofenac diethylammonium + menthol spray under the spray. However, this result needs to be supported by similar studies evaluating early efficacy.