Diclofenac and/or Propacetamol for Postoperative Pain Management After Cesarean Delivery in Patients Receiving Patient Controlled Analgesia Morphine

Siddik, Sahar; Aouad, Marie T.; Jalbout, Maya I.; Rizk, Laudia B.; Kamar, Ghada H.; Baraka, Anis

doi:10.1097/00115550-200107000-00006

Cited by 64 publications

(41 citation statements)

References 26 publications

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“…Siddik SM and colleagues [28] in their study have found improved analgesia and morphine sparing effect with the use of rectal diclofenac but they used intravenous paracetamol instead of oral.…”

Section: Discussionmentioning

confidence: 97%

Postoperative Analgesia Following Caesarean Section: Intravenous Patient Controlled Analgesia Versus Conventional Continuous Infusion

Ismail¹,

Afshan²,

Monem³

et al. 2012

OJAnes

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Background: Management of postoperative pain after caesarean section (CS) requires a balance between pain relief and undesirable side effects of drugs and technique. In order to improve postoperative pain management after caesarean section, we compared intravenous patient controlled analgesia (IV-PCA) with our current hospital practice, which is continuous opioid infusion. Method: We enrolled one hundred and twenty patients in our prospective randomized trial after an uneventful elective caesarean section under spinal anaesthesia. All patients received 0.5 mg/kg bolus of pethidine on first complaint of pain or at 120 minutes after institution of spinal anaesthesia. Depending upon the randomization, Group P received IV-PCA with 0.15 mg/kg bolus pethidine with 10-minute lockout and Group C received continuous pethidine infusion at a rate of 0.15 mg/kg/hr. Statistical Analysis: For qualitative variables means and standard deviations were computed and analyzed by T-test, Mann Whitney U test and repeated measures ANOVA. Frequency and percentages were computed for qualitative data and analyzed by Chi-Square and Fischer exact test. A p-value of less than 0.05 was treated as significant. Results: The numeric rating score for pain, need for rescue analgesia and incidence of nausea and vomiting was significantly lower (p-value < 0.001) in IV-PCA group as compared to continuous infusion group at 6, 12 and 24 hours postoperatively, 98% of the patients were satisfied with pain management in Group P as compared to 70% (p < 0.001) in Group C. Conclusion: Our results showed improved pain control, less need for rescue analgesia for breakthrough pain, lower incidence of nausea and vomiting and greater patient satisfaction with IV-PCA. In the absence of preservative free narcotics for intrathecal use, postoperative pain management can be significantly improved by using IV-PCA instead of continuous opioid infusion in patients undergoing caesarean section.

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Section: Discussionmentioning

confidence: 97%

Postoperative Analgesia Following Caesarean Section: Intravenous Patient Controlled Analgesia Versus Conventional Continuous Infusion

Ismail¹,

Afshan²,

Monem³

et al. 2012

OJAnes

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show abstract

“…6 hourly with diclofenac 100 mg rectally 8 hourly for 24 hours following caesarean section operation. They found that pain was significantly lower in combination group and no difference in incidence of nausea and vomiting [14]. Hyllested et al documented the analgesic efficacy was better in combination than paracetamol alone in regards to pain score, rescue analgesia and pain relief [15].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of the Diclofenac with Different Preparation of Paracetamol for Post-Operative Analgesia Following Laparoscopic Cholecystectomy

Prakash¹

2016

J Anesth Clin Res

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Pain following surgery remains a very important concern which can lead to detrimental effect over cardiovascular system, central nervous system and respiratory system. To minimise pain several analgesics are used. In that matter multimodal analgesia with diclofenac and paracetamol combination is regularly used. The paracetamol available commercially is in different formulation; Paracetamol 100 mL solution for infusion (P), containing paracetamol, cysteine hydrochloride monohydrate, disodium phosphste dihydrate, hydrocholoric acid, mannitol and sodium hydroxide and Paracetamol and lignocaine 2 mL injection (PL), containing paracetamol, lignocaine hydrochloride and benzyl alcohol. We studied comparing both the formulations of these paracetamol in combination with diclofenac in laparascopic surgeries and we did not find any significant difference between these two in terms of demography, VAS, VRS and any other side effects. However the major difference in the cost between these two formulations makes a significant impact in the economic burden.

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“…However, non-steroidal antiinflammatory drugs should be offered after CS as an adjunct to other analgesics, because they reduce the need for opioids 2 . Diclofenac has been shown to produce a significant opioid-sparing effect after caesarean delivery 5,8 . Therefore, we have included it as the first line therapy in our protocol and showed a good compliance according to re-auditing.…”

Section: Discussionmentioning

confidence: 99%

“…Sri Lanka Journal of Obstetrics and Gynaecology JUNE 2017 Audit www.slcog.lk/sljog and vomiting, reactivation of herpes simplex, urinary retention, sedation and delayed respiratory depression, all of which have a higher incidence with intrathecal morphine compared with parenteral opioids 5,8 .…”

mentioning

confidence: 99%

Improvements of post caesarean section pain management following the introduction of a new pain management protocol

Patabendige

Herath

2017

Sri Lanka J Obstet & Gynae

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Diclofenac and/or Propacetamol for Postoperative Pain Management After Cesarean Delivery in Patients Receiving Patient Controlled Analgesia Morphine

Cited by 64 publications

References 26 publications

Postoperative Analgesia Following Caesarean Section: Intravenous Patient Controlled Analgesia Versus Conventional Continuous Infusion

Postoperative Analgesia Following Caesarean Section: Intravenous Patient Controlled Analgesia Versus Conventional Continuous Infusion

A Comparative Study of the Diclofenac with Different Preparation of Paracetamol for Post-Operative Analgesia Following Laparoscopic Cholecystectomy

Improvements of post caesarean section pain management following the introduction of a new pain management protocol

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