title: Comparison of Efficacy and Safety of Intramuscular Piroxicam and Tramadol for Post-operative Pain in Patients Undergoing Caesarean Delivery.
abstract: BACKGROUND
  Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child.
  
  
  OBJECTIVE
  To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain.
  
  
  METHODS
  Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia. Severity of pain was assessed using Visual Analogue Scale (VAS) and side-effects to study drugs were noted. Rescue analgesic butorphanol 2mg was administered if VAS score was more than four. Patient's satisfaction score was assessed at 12 hours post-operatively.
  
  
  RESULTS
  Mean age in piroxicam and tramadol groups were 23.32±3.43 and 22.03±2.0 years respectively. Significant reduction in pain was observed at 2, 4, 8, 12 and 24 hours in both groups (p<0.001). Pain relief was significant at 2, 4 and 8 hours in piroxicam group compared to tramadol. Twenty-one and 12 patients in tramadol and piroxicam groups received rescue analgesic respectively. Sedation and nausea was significantly higher in tramadol group (p<0.001), 46.66% of patients graded their satisfaction score as good and 15% as excellent in piroxicam group.
  
  
  CONCLUSIONS
  Intra-muscular piroxicam was effective in reducing post-caesarean section pain for 24 hours with minimal side-effects compared to tramadol.
authors.affiliation: Postgraduate, Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs University of Higher Education and Research (SDUAHER) , Tamaka, Kolar, Karnataka India .
authors.forename: Tejashree
authors.initials: T
authors.lastname: Thippeswamy
authors.affiliation: Associate Professor, Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs University of Higher Education and Research (SDUAHER) , Tamaka, Kolar, Karnataka India .
authors.forename: Bhuvana
authors.initials: B
authors.lastname: Krishnaswamy
authors.affiliation: Associate Professor, Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs University of Higher Education and Research (SDUAHER) , Tamaka, Kolar, Karnataka India .
authors.forename: Girish M
authors.initials: GM
authors.lastname: Bengalorkar
authors.affiliation: Professor, Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical College, Sri Devaraj Urs University of Higher Education and Research (SDUAHER) , Tamaka, Kolar, Karnataka India .
authors.forename: Narayanaswamy
authors.initials: N
authors.lastname: Mariyappa
keywords: Pain relief; Post-caesarean section pain; Primigravidae