J Med Assoc Thai 2011; 94 (12):52

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Effect of Intramuscular Diclofenac after Explore Laparotomy for Gynecologic Surgery: A Randomized Double-Blinded Placebo Controlled Trial
Thaweekul Y Mail, Suwannarurk K , Maireang K , Poomtavorn Y

Background: Several adjuvant analgesic agents proposed to treat the postoperative pain while reducing the doses of opioid and its derivatives. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in several operative procedures. The present study aimed to demonstrate the morphine-sparing effects of single-dose intramuscular diclofenac sodium in explore laparotomy gynecologic surgery.
Material and Method: Forty-six patients were randomly assigned to receive 75-mg of diclofenac sodium or normal saline with intramuscular morphine during immediate postoperative period. Additional morphine for pain control was given by patient-controlled analgesia. 24-hour morphine consumption, pain score, adverse effects and satisfaction of the patients were recorded.
Results: Median morphine consumption among groups was significant difference between placebo and diclofenac group (32 and 19 mg) (p = 0.041). Greater difference was shown in patients who underwent total abdominal hysterectomy (p = 0.009). Catagorical pain score at 6-hour postoperatively was significant lower in diclofenac group (p = 0.006). No significant difference was found between groups in visual analogue pain score, patients’ satisfaction, presence of bleeding or nausea and vomiting.
Conclusion: The present study demonstrated that single dose of diclofenac sodium has morphine sparing effects and can be safely used in explore laparotomy gynecologic surgery without significant adverse effects.

Keywords: Intramuscular diclofenac, Randomized controlled trial, Gynecologic surgery

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