Jakkrid Surakarn1, Yuen Tannirandorn. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. znop_py@hotmail.com
Abstract
OBJECTIVE: To evaluate the effectiveness of intramuscular diclofenac in postoperative cesarean section pain control. STUDY DESIGN: A randomized controlled trial. SETTING: Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital. SUBJECTS:Eighty patients scheduled for elective cesarean section between October 2007 and April 2008. MATERIAL AND METHOD:All patients had cesarean section performed underspinal anesthesia with spinal morphine and randomized into two groups by a table of randomization. They were to receive diclofenac 75 mg intramuscular every 12 hours for 2 doses or standard rescue drugs (Tramadol). OUTCOME MEASUREMENTS: The number of patients who required rescue drugs, pain score (VAS), side effects of diclofenac, and satisfaction were evaluated for 48 hours postoperatively. RESULTS: In the diclofenac group, no patient required rescue drug compared to 20% of patients in the control group (p < 0.05). Median pain scores were less in the diclofenac group at 6 hours (1 (range 0-6) vs. 4 (range 0-6), p = 0.002), 12 hours (2 (range 0-5) vs. 3 (range 0-7), p = 0.031), and 24 hours (1.5 (range 0-4) vs. 3 (range 1-8), p < 0.0001), respectively. No side effects of diclofenac (e.g., gastrointestinal bleeding, bleeding tendency, uterine atony, or injection site irritation) were observed Satisfaction was comparable in both groups. CONCLUSION:Diclofenac can be used safely to reduce the requirement of rescue drugs for pain control in postoperative cesarean section.
RCT Entities:
OBJECTIVE: To evaluate the effectiveness of intramuscular diclofenac in postoperative cesarean section pain control. STUDY DESIGN: A randomized controlled trial. SETTING: Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital. SUBJECTS: Eighty patients scheduled for elective cesarean section between October 2007 and April 2008. MATERIAL AND METHOD: All patients had cesarean section performed under spinal anesthesia with spinal morphine and randomized into two groups by a table of randomization. They were to receive diclofenac 75 mg intramuscular every 12 hours for 2 doses or standard rescue drugs (Tramadol). OUTCOME MEASUREMENTS: The number of patients who required rescue drugs, pain score (VAS), side effects of diclofenac, and satisfaction were evaluated for 48 hours postoperatively. RESULTS: In the diclofenac group, no patient required rescue drug compared to 20% of patients in the control group (p < 0.05). Median pain scores were less in the diclofenac group at 6 hours (1 (range 0-6) vs. 4 (range 0-6), p = 0.002), 12 hours (2 (range 0-5) vs. 3 (range 0-7), p = 0.031), and 24 hours (1.5 (range 0-4) vs. 3 (range 1-8), p < 0.0001), respectively. No side effects of diclofenac (e.g., gastrointestinal bleeding, bleeding tendency, uterine atony, or injection site irritation) were observed Satisfaction was comparable in both groups. CONCLUSION:Diclofenac can be used safely to reduce the requirement of rescue drugs for pain control in postoperative cesarean section.