Diclofenac and pentazocine versus pentazocine alone for post-operative analgesia in cesarean section

Abstract

Background: Postoperative pain remains one of the greatest concerns during and after cesarean section (CS). Various regimens have been used for post-cesarean pain control including opioids but unfortunately, the intolerability and addictive tendencies of opioids have reduced their acceptability necessitating other more effective and well tolerated alternative. Objective: To determine the effectiveness of diclofenac sodium combined with pentazocine versus pentazocine alone in reducing post-operative pain after CS. Methods: This was an open-label, quasi-randomized clinical trial of 67 women that underwent CS and received either duplet (administration of diclofenac sodium tablets rectally every 12 hours and pentazocine intramuscularly every 6 hours) or single (pentazocine alone) pain treatment, all for 48 hours. Primary outcome measure was visual analogue pain score. Secondary outcome measures were women's satisfaction, commencement of oral sips, mobilization, breastfeeding and return of bowel function including maternal adverse effects. Statistical analysis involved descriptive and inferential statistics at 95% level of confidence using the Epi Info 2008 version 3.5.1. P ≤ 0.05 was considered statistically significant. Analysis was by intention-to-treat. Results: Women receiving duplet treatment, as compared to pentazocine only, experienced less pain (p 0.05). Conclusion: Diclofenac combined with pentazocine significantly reduced pain, increased patient' satisfaction and earlier mobilization during post-cesarean period compared to pentazocine alone.

Keywords

• suppository
• diclofenac
• pentazocine
• pain
• satisfaction
• mobilization
• adverse effects