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Original ArticleOpen Access
Relieving Perineal Pain after Perineorrhaphy by Diclofenac Rectal Suppositories: A Randomized Double-Blinded Placebo Controlled Trial
Achariyapota V 
,
Titapant V
,
Titapant V Background: Perineal pain after episiotomy is a common problem following vaginal birth. The pain affects
either physical or mental function negatively. There are many methods in perineal pain relief, such as local ice
pack and a bath, ultrasound, oral anesthesia, and intravenous anesthesia. Analgesic rectal suppository is one
of various methods in pain relief, especially in drowsy patients, or when oral preparation causes gastric
discomfort, nausea or vomiting.
Objective: To assess the effectiveness of diclofenac rectal suppositories for relief perineal pain after perineorrhaphy.
Design: A randomized double-blinded placebo controlled trial.
Material and Method: Seventy-two term, singleton, pregnant women who gave vaginal birth with second to
third degree episiotomy tears were randomized with envelop concealment to either diclofenac or placebo
rectal suppositories group. Each group received two tablets of 50 mg diclofenac or two tablets of look-alike
placebo rectal suppositories. Visual analogue scale was used for scaling pain score before administration of
the medications, and at 30 minutes, 1, 2, 12, and 24 hours after administration.
Results: No differences were found in the median pain scores before administration of medications and at 30
min, 1 hour, and 2 hour after administration (p > 0.05), while the median pain scores were significantly
reduced in the diclofenac group at 12 and 24 hours after administration compared to the control group (4.5
vs. 0.0; p < 0.001 and 2.0 vs. 0.0; p = 0.02 for 12 hours and 24 hours, consecutively).
Conclusion: The present study suggested that diclofenac suppository was effective on reducing perineal pain
after episiotomy, especially at 12 and 24 hours after administration.
Keywords: Perineal pain, Episiotomy, Diclofenac, Rectal suppositories
either physical or mental function negatively. There are many methods in perineal pain relief, such as local ice
pack and a bath, ultrasound, oral anesthesia, and intravenous anesthesia. Analgesic rectal suppository is one
of various methods in pain relief, especially in drowsy patients, or when oral preparation causes gastric
discomfort, nausea or vomiting.
Objective: To assess the effectiveness of diclofenac rectal suppositories for relief perineal pain after perineorrhaphy.
Design: A randomized double-blinded placebo controlled trial.
Material and Method: Seventy-two term, singleton, pregnant women who gave vaginal birth with second to
third degree episiotomy tears were randomized with envelop concealment to either diclofenac or placebo
rectal suppositories group. Each group received two tablets of 50 mg diclofenac or two tablets of look-alike
placebo rectal suppositories. Visual analogue scale was used for scaling pain score before administration of
the medications, and at 30 minutes, 1, 2, 12, and 24 hours after administration.
Results: No differences were found in the median pain scores before administration of medications and at 30
min, 1 hour, and 2 hour after administration (p > 0.05), while the median pain scores were significantly
reduced in the diclofenac group at 12 and 24 hours after administration compared to the control group (4.5
vs. 0.0; p < 0.001 and 2.0 vs. 0.0; p = 0.02 for 12 hours and 24 hours, consecutively).
Conclusion: The present study suggested that diclofenac suppository was effective on reducing perineal pain
after episiotomy, especially at 12 and 24 hours after administration.
Keywords: Perineal pain, Episiotomy, Diclofenac, Rectal suppositories
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