The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study

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INTRODUCTION: Dexketoprofen/tramadol is a fixed-dose multimodal combination analgesic that significantly controls multiple acute pain states, and may have an important clinical application in providing pain control adequate to prevent the transition from acute to chronic postsurgical and low back pain. A consensus is needed to quantify and define the actual burden of postsurgical pain (PSP) and low back pain (LBP), which can support efforts toward effective approaches to manage potential pain chronification. METHODS: This study utilized a modified Delphi approach. A Scientific Committee set forth 28 statements on six themes about the burden of acute PSP and LBP, their potential transition to chronic pain, their pathophysiology, therapeutic approaches to stop this transition, and the role of multimodal analgesia in this context, specifically a fixed-dose combination oral product of dexketoprofen/tramadol. An international panel of healthcare professionals from various regions and relevant medical specialties participated in a Delphi study and were surveyed for consensus on a 5-point Likert scale with consensus defined as > 70% concordance. A round of online voting lasting 3 months and using an online survey platform was permitted for each participant. RESULTS: A total of 100 experts completed the Delphi survey. All the 28 proposed statements reached consensus > 70% in the first round of voting. A fixed-dose combination product, specifically dexketoprofen/tramadol was recognized as a multimodal analgesic which could effectively relieve acute pain and act to prevent its transition to chronic pain. The high global burden of chronic PSP (CPSP) and chronic LBP (CLBP) was identified as well. CONCLUSIONS: Healthcare professionals who deal with pain recognize the burden of acute pain, the risks of acute pain transitioning to chronic pain, and inspire to avert the transition by providing effective multimodal control of acute pain. The role of fixed-dose combination analgesics, in particular dexketoprofen/tramadol, was recognized by consensus as an efficacious and safe therapy option for these acute pain syndromes. A Video Abstract is available for this article. To view, please see the online version of the manuscript or follow the 'Digital Features' link. A Video Abstract for The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study (MP4 112565 KB).

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