Title: Rectal Versus Intramuscular Diclofenac Sodium for Pain Relief Following Caesarean Section: A Randomised Controlled Trial
Authors: Otutoaja Uzoma, Adeniyi Augustine Adebayo, Bakare Adewumi, Orewole Olayinka Tesleem, Adewara Emmanuel Olumide, Okere Raymond Akujuobi, Awoyinka Babatunde, Adebara Idowu Oluseyi, Adeyemo Timothy Olabisi, Ayankunle Mojisola O, Busari Olusegun
DOI: https://dx.doi.org/10.18535/jmscr/v6i8.103
Abstract
Introduction: Patients who undergo caesarean delivery should have adequate postoperative pain relief so as to ensure maternal and neonatal wellbeing. Management of postoperative pain after caesarean section requires a balance between pain relief and undesirable side effects of drugs and route of administration. This study was designed to compared the analgesic efficacy of rectal diclofenac and intramuscular diclofenac for pain relief following caesarean section.
Method: A total number of sixty six (66) patients undergoing elective lower segment caesarean delivery under spinal anaesthesia were randomized into two groups. Thirty-three (33) patients in each group received either 100mg of rectal diclofenac sodium or 75mg of intramuscular diclofenac sodium for duration of 24 hours, following caesarean section.
Results: Fewer patients in the rectal arm had rescue analgesia,12(42.86%) vs 16(57.14%), P=0.21. The number of rescue analgesia was also lower in the rectal group, 16(41.03%) vs 23(58.97%), P=0.027. The time interval between commencement of post-operative analgesia and demand for rescue analgesic agent was similar in both group 4.28 ± 2.78 hours and 3.98 ± 2.52 hours respectively, P=0.77. The pain scores were higher in the intramuscular diclofenac group at 6, 12, 18 and 24 hours post operation. Side effects occur more frequently in the intramuscular group than in the rectal group but patients' satisfaction was similar in both groups, rectal (84.8%) and intramuscular (78.8%), P=0.612.
Conclusion: Both routes of administration demonstrate good pain control, however rectal route appears more tolerable among the patients.
Keywords: Post Caesarean pain, Diclofenac, administration.
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