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-α) in neuropathic pain. Methods: Subjects were randomized post-test only control group design from 28 mice (Mus musculus) to 4 groups: G₀ (control), G₁ (paracetamol only), G₂ (cacao + paracetamol), and G₃ (cacao + ½ doses paracetamol). The subject assessed pain scale using von Frey test and TNF-α. 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 G₀ (p = 0.006), G₁ (p <0.001), G₂ (p <0.001), and G₃ (p <0.001). After treatment, the average TNF-α 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-α 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-α levels.