The Effects of either Diclofenac Suppository , Intravenous Acetaminophen or their Combination on the Severity of Postoperative Pain in Patients Undergoing Spinal Analgesia during Cesarean Section

Abstract

Background: For pain relief after cesarean operation, various drugs such as opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are used. Due to complications of opioids, particular attention has been paid to NSAIDs, and the physicians use these drugs as useful analgesics in controlling different types of pain. This study was performed in order to assess the effect of either diclofenac suppository, intravenous acetaminophen or their combination on decreasing the severity of postoperative pain in patients undergoing spinal analgesia for cesarean section. Methods: This was clinical trial study in Zagazig University Maternity Hospital during the period from August 2017 to December 2017. Included 48 patients undergoing cesarean section. The patients were randomly divided (by alternation) into three groups 16 patients, group A: 100 mg diclofenac suppository, group B: 1000mg acetaminophen through Intravenous injection of infusion in 200 ml 0.9% saline, group C: 100 mg diclofenac suppository and 500 mg intravenous acetaminophen. All patients underwent full clinical evaluation and pain follow up for 24 hours. At the end of surgery, pain severity was assessed according to VAS scale at different times. Results: During the study, the least mean pain severity was found in the combination group and the highest was observed in the diclofenac group. There was significant difference of times of additional doses of analgesia which high in group diclofenac then group acetaminophen and the least times detected at combination group. Conclusion: The combination of Acetaminophen and Diclofenac has better and longer analgesic effects than sole use administration of each drugs.