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Introduction <p>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.</p> Methods <p>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 &gt; 70% concordance. A round of online voting lasting 3&#xa0;months and using an online survey platform was permitted for each participant.</p> Results <p>A total of 100 experts completed the Delphi survey. All the 28 proposed statements reached consensus &gt; 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.</p> Conclusions <p>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.</p> <p><MediaObject ID="MOESM1"> <VideoObject FileRef="MediaObjects/40122_2025_786_MOESM1_ESM.mp4" VideoID="7KDL7wDHZ5GDvGppW1iD89"> <Caption Language="En" xml:lang="en"> <CaptionContent> <p>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)</p> </CaptionContent> </Caption> </VideoObject> </MediaObject></p>

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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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  • 发表日期：

    2025年11月1日

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  • Giustino Varrassi,
  • Maria Dolma Gudez-Santos,
  • Magdi Hanna,
  • Magdalena Kocot-Kępska,
  • Antonio Montero Matamala,
  • Marco Antonio Narvaez Tamayo,
  • Serge Perrot,
  • Jose Luis Aguilar,
  • Omar Al Hamad,
  • Lu’i Al-Husinat,
  • Raad Al-Khafaji,
  • Abdallah Allam,
  • Ezio Amorizzo,
  • Nadine Attal,
  • Amany Ezzat Ayad,
  • Rosaria Barbano,
  • Matthias Behrends,
  • Adrian Belîi,
  • Alexandru Beţişor,
  • Arun Bhaskar,
  • Adriana María Buriticá,
  • Paul Calleja,
  • Stefano Coaccioli,
  • Josè Cordova,
  • Jose Rhoel C. De Leon,
  • Oscar Pasquale DeDe Leon CasasolaNegri,
  • Merle Dela Cruz-Odi,
  • Alain Delbos,
  • Alexander Delgadillo Soriano,
  • Cesar Cipriano de Leon Dimayuga,
  • Reis Drudis,
  • Tolga Ergönenç,
  • Victor Espinoza Aranguren,
  • Gabriele Finco,
  • Victor Alejandrino Galarreta Sánchez,
  • Xavier Garcia-Eroles X,
  • Anastasia Garneli,
  • Helen Gharaei,
  • Jose Ariel Giraldo Florez,
  • Lora Gîţu,
  • Patricia Gomez,
  • Branko Granić,
  • Maria Jose Groizard,
  • Carlos Guerrero,
  • Denisa Klir,
  • Sevala Hebibovic,
  • László Herczeg,
  • Hamlet ernández,
  • Farnad Imani,
  • Pablo Ingelmo,
  • Marcin Janecki,
  • Francis Ocampo Javier,
  • Alexandra Kotlińska-Lemieszek,
  • Alen Kristić,
  • Marica Kristić,
  • Marco Lacerenza,
  • Rudolf Likar,
  • Michael Joseph T. Magabo,
  • Victor Mayoral,
  • Francisco Javier Medel Rebollo,
  • Marco Mercieri,
  • Fabrizio Micheli,
  • Josè Angel Montañes,
  • Vedrana Mužić Radović,
  • Horacio Najera,
  • Teresa Nava Obregon,
  • Felice Occhigrossi,
  • Leonardo Ona,
  • Monica Osio-Saldaña,
  • Antonella Paladini,
  • Marco Palumbo,
  • Joseph V. Pergolizzi Jr,
  • Enrico Polati,
  • Daiana Popa,
  • Anna Przeklasa-Muszyńska,
  • Filomena Puntillo,
  • Lucy Nely Quispe Josig,
  • Martina Rekatsina,
  • Riccardo Rinaldi,
  • Vladimir Romanenko,
  • Robert Rupinski,
  • Jose Antonion M. Salud,
  • Daniel Samper,
  • Stephan Schug,
  • Vittorio Schweiger,
  • Anna Server Salvà,
  • Remus Sebastian Sipos,
  • Jose María Sistac,
  • Bajro Slatina,
  • Maria Lilybeth R. Tanchoco,
  • Beata Tarnacka,
  • Knox Todd,
  • Erik Toomas,
  • Mongi Touzi,
  • Anne Priscille Trouvin,
  • Theofilos Tsoleridis,
  • Athina Vadalouca,
  • Cesar Edwin Vela Izquierdo,
  • Villalobos Carlo Alberto Fuenmayor,
  • Thomas Volk,
  • Edward Hsiao-Meng Wang,
  • Hai-Qang Wang,
  • Jerzy Wordliczek,
  • Ece Yamak Altinpulluk,
  • Nune Yeghiazaryan,
  • Renata Zajączkowska,
  • Jūlija Zamotkina,
  • Ignas Zasimavičius

摘要

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)