Combination of suppository diclofenac and intravenous morphine infusion in post-caesarean section pain relief--a step towards balanced analgesia?
Post-Caesarean section analgesia can be achieved by morphine infusion. NSAIDs are frequently administered to relieve uterine cramps. This study is aimed at assessing the efficacy of the combination of suppository diclofenac and morphine infusion in post-Caesarean section pain relief. General anaesthesia was given to 60 patients who were randomly allocated into two groups: group A received 100 mg suppository diclofenac before surgical incision and morphine infusion 1.5 mg per hour postoperatively while group B received only morphine infusion 1.5 mg/H postoperatively. Pain assessment was done by an unbiased observer on arrival of the patients in the recovery room, then 6 hours, 12 hours and 24 hours later. Pain relief was found to be better in group A, with group B requiring more supplemental analgesia. Apart from better analgesic effect for wound pain, group A also had more favourable scores for uterine cramping pain. The incidence of nausea or vomiting was similar in both groups. No respiratory depression was observed in both groups. Two cases of increased bleeding (one from each group) were observed, both receiving conservative treatment.


CONCLUSIONS
suppository diclofenac improved the analgesic efficacy of morphine infusion in post-Caesarean analgesia.
Sia
A T
AT
Department of Anaesthesia, Kandang Kerbau Hospital, Singapore.
Thomas
E
E
Chong
J L
JL
Loo
C C
CC
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002585:Cesarean Section; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D010149:Postoperative Pain / Q000188:drug therapy*; D010570:Pessaries; D011247:Pregnancy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac