The use of rectal diclofenac for post-cesarean analgesia

OBJECTIVE: To determine whether the prophylactic use of rectal diclofenac sodium produces effective analgesia after cesarean section.

METHODS: A randomized single blind controlled trial. The study period was from September 1997 - April 1998. Forty patients undergoing both emergency and elective cesarean section were studied, with 20 patients in each arm. The study group received 100 mg rectal diclofenac immediately after cesarean section followed by 50 mg at 12 hours and 100 mg at 36 hours after the surgery. The control group did not receive any diclofenac suppositories.

RESULTS: The results showed that the visual analogue score for pain in the study group was significantly less at 12, 18 and 24 hours after surgery (P <0.05). The amount of pethidine consumed was also significantly less (P <0.05) with 28 injections consumed in the study group as compared with 52 in the control group (each pethidine injection = 100 mg). The incidence of sedation and constipation was significantly less (P<0.05) in the study group. However, the incidence of nausea and post-operative pyrexia was comparable in the 2 groups.

CONCLUSION: Rectal diclofenac provides effective analgesia when given after cesarean section. It also reduces the patients opioid requirements with a corresponding reduction in the opioid related side-effects.