PENTAZOCINE VERSUS PENTAZOCINE WITH RECTAL DICLOFENAC FOR POSTOPERATIVE PAIN RELIEF AFTER CESAREAN SECTION- A DOUBLE BLIND RANDOMIZED PLACEBO CONTROLLED TRIAL IN A LOW RESOURCE AREA.

Abstract

BACKGROUND: The unimodal approach of using pentazocine as post-cesarean section pain relief is inadequate, hence the need for a safer, easily available and more effective multimodal approach. AIM: To evaluate the effectiveness of rectal diclofenac combined with intramuscular pentazocine for postoperative pain following cesarean section. METHODS: In this double blind clinical trial, 130 pregnant women scheduled for cesarean section under spinal anesthesia were randomly assigned to two groups. Group A received 100mg diclofenac suppository and group B received placebo suppository immediately following surgery, 12 and 24h later. Both groups also received intramuscular pentazocine 30mg immediately following surgery and 6 hourly postoperatively in the first 24 h. Postoperative pain was assessed by visual analogue scale at end of surgery and 2, 12 and 24 h after surgery. Patient satisfaction scores were also assessed. RESULTS: One hundred and sixteen patients completed the study. Combining diclofenac and pentazocine had statistically significant reduction in pain intensity at 2, 12, and 24 hours postoperatively compared to pentazocine alone (p <0.05). No significant side effects were noted in both groups. The combined group also had significantly better patient satisfaction scores. CONCLUSION: The addition of diclofenac suppository to intramuscular pentazocine provides better pain relief after cesarean section and increased patient satisfaction.

Type

Journal article

Department

Description

Provenance

Subjects

Adult, Analgesics, Opioid, Anti-Inflammatory Agents, Non-Steroidal, Diclofenac, Double-Blind Method, Female, Health Resources, Humans, Pain, Postoperative, Patient Satisfaction, Pentazocine, Pregnancy, Suppositories, Visual Analog Scale

Citation

Scholars@Duke

Olufolabi

Adeyemi John Olufolabi

Professor of Anesthesiology

My interests include obstetric and gynecological anesthesia research. This includes the use of opioids in obstetric population.  I also have an interest in the management of the difficult airway in general anesthesia and in the Obstetric population. More recently, I have been engaged in global health and the role of anesthesia in resolving the disparity gap.  I have a particular interest in anesthesia in sub-sahara Africa and have been involved in capacity building, research and educational endeavors in that sphere.


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