title: Topical diclofenac patch for postoperative wound pain in laparoscopic gynecologic surgery: a randomized study.
abstract: OBJECTIVE
  To compare pain management of standard analgesic and standard analgesic plus diclofenac transdermal patch in patients who undergo laparoscopic gynecologic surgery.
  
  
  METHODS
  Randomized prospective study (Canadian Task Force classification I).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred twenty patients requiring laparoscopic surgery for gynecologic benign diseases.
  
  
  METHODS
  Patients were divided into two groups, one medicated with a diclofenac patch (diclofenac group) and the other medicated with standard skin medication (placebo; control group) at all incisional areas at the end of the operation.
  
  
  RESULTS
  The principal measures of outcome were pain intensity at 6, 12, and 24 hours after surgery and consumption of analgesics. The two treatment groups were comparable with respect to demographic and intraoperative characteristics. No significant difference was observed between the two groups in mean pain intensity at 6 hours after surgery. Mean pain intensity at 12 and 24 hours, respectively, after surgery was significantly lower in the diclofenac group (3.7 +/- 1.3 and 2.0 +/- 0.6) than that observed in the control group (5.7 +/- 1.9 and 4.6 +/- 0.5) (p value, respectively, .002 and <.001). Twenty-one patients (35.0%) in the diclofenac group required analgesics in the first 36 hours after the operation versus 43 patients (71.7%) in the control group (p <.001). Hospital discharge was significantly more rapid in the diclofenac group (28 +/- 5 hours vs 39 +/- 3 hours; p = .031).
  
  
  CONCLUSIONS
  Diclofenac transdermal administration seems a valid help to standard analgesic treatment in postoperative pain control and could also help reduce the period of hospitalization of patients who undergo laparoscopic benign gynecologic surgery.
authors.affiliation: Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Genoa, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Alessandri
authors.forename: Davide
authors.initials: D
authors.lastname: Lijoi
authors.forename: Emanuela
authors.initials: E
authors.lastname: Mistrangelo
authors.forename: Annamaria
authors.initials: A
authors.lastname: Nicoletti
authors.forename: Marco
authors.initials: M
authors.lastname: Crosa
authors.forename: Nicola
authors.initials: N
authors.lastname: Ragni
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac