Management of Postcaesarean Delivery Analgesia-Diclofenac Suppository, Paracetamol Infusion and a Combination
Introduction: One of the most important aspect of postoperative care is pain management which plays an important role in early recovery and improves patient’s general condition. Paracetamol and diclofenac have an excellent safety profile when compared to opioids. Aim: To assess and compare the...
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| Autores principales: | , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/ec8701e89b674cf6a85036f404304e59 |
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| Sumario: | Introduction: One of the most important aspect of postoperative
care is pain management which plays an important role in early
recovery and improves patient’s general condition. Paracetamol
and diclofenac have an excellent safety profile when compared
to opioids.
Aim: To assess and compare the analgesic efficacy and safety
of individual use of Intravenous (IV) paracetamol, diclofenac
suppository and in combination.
Materials and Methods: This hospital-based cross-sectional study
was conducted from October 2018 to June 2020 at Department of
Obstetrics and Gynaecology. A total of 90 women who underwent
caesarean section were recruited for the study and were randomly
allocated (lottery method) into three groups with 30 participants in
each group. The patients underwent Lower Segment Caesarean
Section (LSCS) under spinal anaesthesia with the same technique
and medicine, (Bupivacaine 0.5%) without receiving any sedation.
Group A patients received diclofenac suppository 50 mg every
eight hourly, Group B received paracetamol infusion 1000 mg every
eight hourly and Group C received 50 mg diclofenac suppository
and 500 mg IV paracetamol every eight hourly. Pain severity (Visual
Analogue Scale (VAS) score), Heart Rate (HR), Blood Pressure
(BP) and side-effects were evaluated at 2,4,6,8,12 and 24 hours
postoperatively. Patient satisfaction score was evaluated 24 hours
after caesarean section.
Results: Age range of participants was 19 to 28 years. Mean duration
of surgery (minutes) in each group were- Group A-56.5±7.49,
Group B-58.27±8.06 and Group C-56.97±6.78, respectively. There
was a significant reduction of pain in patients receiving paracetamol
and diclofenac suppository combination group. The satisfaction
score was categorised as excellent by 80% patients in Group C.
In Group A 30% and in Group B 16.6% categorised as excellent
patient satisfaction score. The adverse effects such as nausea and
epigastric discomfort was higher (7.7%) with diclofenac suppository
group followed by Paracetamol (2.2% side-effects) and minimal
with combination (1%).
Conclusion: Paracetamol infusion is as effective as diclofenac
suppository in reducing postoperative pain following caesarean
section. Diclofenac suppository and IV paracetamol combination
provides more effective postoperative analgesia compared with
individual usage of IV paracetamol or diclofenac suppository
in patients following caesarean section. The combined use of
paracetamol and diclofenac suppository has fewer side-effects
compared with individual use of either IV paracetamol or diclofenac
suppository |
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