Comparative Study of Parenteral Diclofenac and Pentazocine for Post-Caesarean Analgesia after Subarachnoid Block

Abstract

Background: Pain in the immediate post-operative period is still a significant problem and a cause of concern for majority of women who undergo caesarean delivery. Use of a non-steroidal anti-inflammatory drug as part of the analgesic regimen may be important in the recovery process after caesarean delivery. The aim of this study was to compare the post-operative analgesic efficacy of diclofenac and pentazocine after caesarean delivery done under spinal anaesthesia.
Patients and Methods: Eighty-four patients, who had elective caesarean section under subarachnoid block, were randomized into two equal groups. Patients in Group 1 had intramuscular diclofenac 75mg and those in Group 2 had intramuscular pentazocine 30 mg after completion of skin closure. Tramadol, 50mg, was administered intravenously as rescue analgesic for both groups. Data collected included time to first request for rescue analgesic, pain intensity scores using Visual Analogue Scale (VAS); and patients' satisfaction with pain management. VAS scores were analyzed with analysis of variance (ANOVA) repeated measures. P-value <0.05 was considered statistically significant.
Results: Both study groups had similar patients' characteristics. Time to first request for rescue analgesic was delayed in Group 1 - 241.94 ± 17.26 minutes compared to group 2 that was 169.25±36.82 minutes (p <0.05). Group 1 patients requested for rescue analgesic less often compared to group 2. Both groups were similar with respect to patients' satisfaction and incidence of side-effects.
Conclusion: Intramuscular diclofenac provided longer duration of analgesic effects post-caesarean section compared to intramuscular pentazocine in this study.

Keywords: Post-caesarean section analgesia, diclofenac, pentazocine.