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Table 4 The effect of vitamin C on opioid analgesic requirements

From: The role of vitamin C in the treatment of pain: new insights

Study type Intervention Findings
Placebo controlled RCT
 Laparoscopic colectomy—for colon cancer [97] i. Placebo (N = 48) i. 16 mg morphine at 2 h, frequency of rescue analgesia: 1.4
ii. 50 mg IV vitamin C/kg body weight (N = 49) prior to surgery ii. 14 mg morphine at 2 h*, frequency of rescue analgesia: 0.8*, ↓ pain at 2, 6, 24 h (NRS)*
 Uvulopalatopharyngoplasty with tonsillectomy [98] i. Placebo (N = 20) i. 46 mg pethidine, first dose at 3 h, number of requests: 1.3
ii. 3 g IV vitamin C (N = 20) 30 min into surgery ii. 6 mg pethidine*, first dose at 12 h*, number of requests: 0.2*, ↓ pain at 6, 12, 24 h (VAS)*
 Cholecystectomy [99] i. Placebo (N = 40) i. 23 mg morphine
ii. 2 g oral vitamin C (N = 40) prior to surgery ii. 16 mg morphine* (at 24 h follow up)
Uncontrolled prospective
 Range of malignancies [96] 2 g oral vitamin C (N = 17) for 3 days Before: 360 mg/day opioids After: 390 mg/day opioids
Controlled retrospective
 Terminal cancer [82] i. Control (N = 19) i. 79% required narcotics
ii. 0.5–3 g/day oral vitamin C (N = 6) ii. 50% required narcotics
iii. 5–30 g/day oral vitamin C (N = 6) iii. 17% required narcotics
Case report
 Intolerable fibrosarcoma-related pain [81] 10 g/day vitamin C for 19 days Better control of pain by opiates
 Breast cancer with skeletal metastases—severe pain [81] 5 g/day IV vitamin C for 7 days No further need for opiates (from day 4)
8 g/day oral vitamin C for 70 days
 Bladder cancer with skeletal metastases—intense pain inadequately controlled by morphine [81] 10 g/day IV vitamin C for 10 days No further need for opiates
10 g/day oral vitamin C for 24 days
  1. IV intravenous, NRS numeric rating scale, VAS visual analogue scale
  2. P < 0.05