title: Analgesic Efficacy of Diclofenac and Paracetamol vs. Meperidine in Cesarean Section.
abstract: BACKGROUND
  One of the most important complications in cesarean surgery is postoperative pain, and different ways have been proposed to control it.
  
  
  OBJECTIVE
  The purpose of this study was to determine the efficacy of Diclofenac and Paracetamol combination in comparison with Meperidine on postoperative pain after cesarean surgery.
  
  
  METHODS
  One hundred and twenty women candidates for elective cesarean section under spinal anesthesia categorized as ASA class I were selected and randomly assigned to receive either Diclofenac suppository at the end of the operation and thereafter 1 gram infused bolus of Paracetamol (group A), or 20 mg bolus of Meperidine after transition to recovery room (group B) to control postoperative pain.
  
  
  RESULTS
  Postoperative pain was present in recovery in 38.3% and 23.3% in groups B and A, respectively (P = 0.009). Postoperative pain was seen after six hours of operation in 38.7% and 16.7% in groups B and A, respectively (P = 0.010). Postoperative pain was present after 12 hours of operation in 38.3% and 15% in groups B and A, respectively (P = 0.002). The additive Meperidine use was the same between the two groups in recovery (P > 0.05). The additive Meperidine use was seen after six hours of operation in 26.7% and 6.7% in groups B and A, respectively (P = 0.013). The additive Meperidine use was seen after 12 hours of operation in 16.7% and none of the patients in groups B and A, respectively (P = 0.004). The frequency of drug adverse effects was the same between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  Totally, according to the obtained results it may be concluded that Paracetamol and Diclofenac combination would have a better efficacy in postoperative pain control and need reduction to additive analgesia compared to Meperidine.
authors.affiliation: Anesthesiology Department, Amiralmomenin Hospital, Islamic Azad University, Tehran Medical Branch, Tehran, IR Iran.
authors.forename: Heidar
authors.initials: H
authors.lastname: Darvish
authors.affiliation: Anesthesiology Department, Amiralmomenin Hospital, Islamic Azad University, Tehran Medical Branch, Tehran, IR Iran.
authors.forename: Behrouz
authors.initials: B
authors.lastname: Memar Ardestani
authors.affiliation: Department of Medical Researches, Islamic Azad University, Tehran Medical Branch, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Mohammadkhani Shali
authors.affiliation: Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Tajik
keywords: Acetaminophen; Cesarean Section; Diclofenac; Meperidine; Pain, Postoperative