title: The Effects of Diclofenac Suppository and Intravenous Acetaminophen and their Combination on the Severity of Postoperative Pain in Patients Undergoing Spinal Anaesthesia During Cesarean Section.
abstract: BACKGROUND
  The main tasks of postoperative care are postoperative pain and complications control which play an important role in accelerating the recovery of patient's general condition.
  
  
  OBJECTIVE
  This study was performed in order to compare the effects of diclofenac suppository, intravenous acetaminophen and their combination on the severity of postoperative pain in patients undergoing spinal anaesthesia for cesarean section in Sayyad Shirazi teaching Hospital, Gorgon, Iran.
  
  
  METHODS
  This was a double-blind clinical trial on 90 patients undergoing cesarean section. The patients were randomly divided into three groups, group A: 100 mg diclofenac suppository, group B: 1000 mg intravenous acetaminophen, group C: 100 mg diclofenac suppository and 500 mg intravenous acetaminophen. The same spinal anaesthesia circumstances were applied for all the participants. At the end of surgery, pain severity was assessed according to VAS scale at different times. Data were then analysed by SPSS 18 statistical software.
  
  
  RESULTS
  The mean age of participants was (28.27±6.07). There was significant difference between the mean pain scores of the three groups before the intervention (p=0.018), which was considered as co-variate. This difference was more notable between the combination of acetaminophen - diclofenac group and diclofenac alone. After the intervention, significant difference was observed in mean pain severity between acetaminophen group and the combination group and also between diclofenac and the combination group. During the study, the least mean pain severity was found in the combination group and the highest was observed in the diclofenac group.
  
  
  CONCLUSIONS
  Results of this study indicates a significant effect of concomitant use of intravenous acetaminophen and diclofenac suppository on pain severity reduction and reducing the need for repeated doses of narcotics and prolonging the postoperative analgesia.
authors.affiliation: Lecturer, Department of Anesthesia, Laboratory Sciences Research Center, Golestan University of Medical Sciences , Gorgan, Iran .
authors.forename: Fozieh
authors.initials: F
authors.lastname: Bakhsha
authors.affiliation: Anesthesiologist, Department of Anesthesia, Sayad Shirazi Medical & Education Center, Golestan Unaiversity of Medical Sciences , Gorgan, IR Iran .
authors.forename: Alireza Seyedi
authors.initials: AS
authors.lastname: Niaki
authors.affiliation: Lecturer, Department of Anesthesia, Laboratory Sciences Research Center, Golestan University of Medical Sciences , Gorgan, Iran .
authors.forename: Seyed Yaghoub
authors.initials: SY
authors.lastname: Jafari
authors.affiliation: Lecturer, Department of Nursing, Laboratory Sciences Research Center, Golestan University of Medical Sciences , Gorgan, Iran .
authors.forename: Zahra
authors.initials: Z
authors.lastname: Yousefi
authors.affiliation: Lecturer, Department of Epidemiology, Health Management and Social Development Research Center, Golestan University of Medical Sciences , Gorgan, Iran .
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aryaie
keywords: Pain management; Pain relief; Paracetamol; Postoperative complications