Effect of intravenous diclofenac on pain and recovery profile after day-case laparoscopy.
Diclofenac sodium, 100 mg, or saline was given intravenously after the induction of anaesthesia to 169 patients undergoing outpatient gynaecological diagnostic laparoscopy or laparoscopic sterilization by tubal ligation. Propofol was used as the main anaesthetic agent and fentanyl and paracetamol were given for post-operative pain relief. In the post-anaesthesia care unit the amount of analgesics given and the incidence of nausea and vomiting were recorded. The time until oral intake, voiding and walking without assistance were recorded as parameters of recovery and guidelines for discharging the patient. In the diagnostic laparoscopy group, the patients given diclofenac needed significantly (P < 0.05) less fentanyl (25 +/- 33 micrograms, mean +/- SD) and paracetamol (230 +/- 40 mg) for post-operative pain than the patients given saline (fentanyl 47 +/- 53 micrograms and paracetamol 690 +/- 100 mg), which was not the case in the tubal ligation group. However, patients in the tubal ligation group needed significantly more post-operative analgesia than patients in the laparoscopy group. Diclofenac had no influence on the rapidity of recovery or home readiness in either group. It is concluded that diclofenac has no influence on home readiness, but prevents postoperative pain in patients undergoing diagnostic laparoscopies, whereas it was not a potent enough analgesic to prevent pain after laparoscopic tubal ligation.
Hovorka
J
J
Department of Anaesthesia, Women's Clinics, Helsinki University, Finland.
Kallela
H
H
Korttila
K
K
D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000553:Ambulatory Care; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D010535:Laparoscopy / Q000009:adverse effects*; D009325:Nausea / Q000209:etiology; D010146:Pain / Q000517:prevention & control*; D010149:Postoperative Pain / Q000517:prevention & control; D010919:Placebos; D013245:Sterilization, Reproductive / Q000009:adverse effects; D014554:Urination; D014839:Vomiting / Q000209:etiology; D016138:Walking
D010919:Placebos; D004008:Diclofenac; D000082:Acetaminophen; D005283:Fentanyl