title: PENTAZOCINE VERSUS PENTAZOCINE WITH RECTAL DICLOFENAC FOR POSTOPERATIVE PAIN RELIEF AFTER CESAREAN SECTION- A DOUBLE BLIND RANDOMIZED PLACEBO CONTROLLED TRIAL IN A LOW RESOURCE AREA.
abstract: BACKGROUND
  The unimodal approach of using pentazocine as post-cesarean section pain relief is inadequate, hence the need for a safer, easily available and more effective multimodal approach.
  
  
  OBJECTIVE
  To evaluate the effectiveness of rectal diclofenac combined with intramuscular pentazocine for postoperative pain following cesarean section.
  
  
  METHODS
  In this double blind clinical trial, 130 pregnant women scheduled for cesarean section under spinal anesthesia were randomly assigned to two groups. Group A received 100mg diclofenac suppository and group B received placebo suppository immediately following surgery, 12 and 24h later. Both groups also received intramuscular pentazocine 30mg immediately following surgery and 6 hourly postoperatively in the first 24 h. Postoperative pain was assessed by visual analogue scale at end of surgery and 2, 12 and 24 h after surgery. Patient satisfaction scores were also assessed.
  
  
  RESULTS
  One hundred and sixteen patients completed the study. Combining diclofenac and pentazocine had statistically significant reduction in pain intensity at 2, 12, and 24 hours postoperatively compared to pentazocine alone (p <0.05). No significant side effects were noted in both groups. The combined group also had significantly better patient satisfaction scores.
  
  
  CONCLUSIONS
  The addition of diclofenac suppository to intramuscular pentazocine provides better pain relief after cesarean section and increased patient satisfaction.
authors.forename: Simeon O
authors.initials: SO
authors.lastname: Olateju
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Adenekan
authors.forename: Adeyemi J
authors.initials: AJ
authors.lastname: Olufolabi
authors.forename: Afolabi M
authors.initials: AM
authors.lastname: Owojuyigbe
authors.forename: Adedapo O
authors.initials: AO
authors.lastname: Adetoye
authors.forename: Kayode O
authors.initials: KO
authors.lastname: Ajenifuja
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Olowookere
authors.forename: Aramide F
authors.initials: AF
authors.lastname: Faponle
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006295:Health Resources; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D010423:Pentazocine / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D013488:Suppositories; D064232:Visual Analog Scale
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D013488:Suppositories; D004008:Diclofenac; D010423:Pentazocine