Single-dose intravenous diclofenac for acute postoperative pain in adults

Abstract

The amount and quality of evidence for the use of intravenous diclofenac as a treatment for postoperative pain is low. The available evidence indicates that postoperative intravenous diclofenac administration offers good pain relief for the majority of patients, but further research may impact this estimate. Adverse events appear to occur at a similar rate to other NSAIDs. Insufficient information is available to assess whether intravenous diclofenac has a different rate of bleeding, renal dysfunction, or cardiovascular events versus other NSAIDs. There was insufficient information to evaluate the efficacy and safety of newer versus traditional formulations of intravenous diclofenac. There was a lack of studies in major and cardiovascular surgeries and in elderly populations, which may be at increased risk for adverse events.

Analysis of clinical efficacy and safety of intravenous use of diclofenac for the prevention of postoperative pain: current status and strategic aspect

“…The results of the Cochrane review (2018) of 8 studies involving 1756 people in whom diclofenac was administered intravenously to relieve pain after surgery in adults indicate that diclofenac is more effective than placebo and similar to other NSAIDs. Studies did not provide sufficient information on adequate assessment of side effects, but their incidence was similar to that seen with other treatments [25].…”

An observational study to evaluate the prescription pattern of analgesics used in the perioperative period in a tertiary care hospital

“…Diclofenac is an established NSAID used in the management of acute and chronic pain states. [ 17 ] Diclofenac in oral form has limited efficacy in treating acute postoperative pain. [ 18 ] A meta-analysis on NSAID's effect on the postoperative renal function of 1459 healthy individuals revealed that the use of NSAID led to a very transient decrease in creatinine clearance postsurgery.…”

Tilidine and dipyrone (metamizole) in cold pressor pain: A pooled analysis of efficacy, tolerability, and safety in healthy volunteers

“…Pain intensity: Percent area under the pain curve Pain intensity was assessed as percent area under the pain curve (%AUPC) according to Koltzenburg et al 9 The %AUPC corresponds to the averaging pain rating given over the full duration of the CPT, divided by the highest possible AUPC value (= 100 VAS units * 180 s), whereas the maximum VAS rating (100 units) is carried forward to 180 s for participants who terminated testing early. 9 Thus, a higher %AUPC denotes higher individual pain sensitivity, with 0% AUPC denoting complete pain insensitivity for the full testing duration and 100% AUPC denoting the immediate termination of testing due to pain intolerance, or, equivalently, a constant VAS rating of 100 for 180 s. The AUPC has been shown to be a reliable marker for pain intensity in both healthy participants and patients, [23][24][25] and to be sensitive for detecting opioid analgesia. 9…”