Effect of Cacao Bean Extract as a Paracetamol Adjuvant on Pain Scale and Tumor Necrosis Factor-Alpha in Neuropathic Pain: An Animal Model Study

Introduction: One treatment for neuropathic pain is paracetamol.Meanwhile, cacao bean extract is a traditional remedy developed for pain management.Objective: Analyzing effect of combining cacao bean extract and paracetamol on pain scale and tumor necrosis factor-alpha (TNF-) in neuropathic pain.Methods: Subjects were randomized post-test only control group design from 28 mice (Mus musculus) to 4 groups: G 0 (control), G 1 (paracetamol only), G 2 (cacao + paracetamol), and G 3 (cacao + doses paracetamol).The subject assessed pain scale using von Frey test and TNF-.The statistical analysis includes paired t-tests, Wilcoxon, one-way ANOVA, Kruskal Wallis, and Pearson correlation tests with p <0.05.Results: The combination of cacao bean extract and paracetamol resulted in a pain scale of 2.57 1.10 gf, with significant differences observed among the four groups (p <0.001).Significant differences in pain scale scores were found in four groups (p <0.001), including G 0 (p = 0.006), G 1 (p <0.001), G 2 (p <0.001), and G 3 (p <0.001).After treatment, the average TNF- levels was 86.96 23.73 ng/mL, with significant differences observed among the four groups (p <0.001).There was a strong correlation between the pain scale and TNF- levels (p <0.001).Conclusion: In an animal model of neuropathic pain, using cacao bean extract as a paracetamol adjuvant significantly reduces pain scale (as measured by the von Frey test) and TNF- levels.