A randomized controlled trial of rectal diclofenac sodium and intramuscular pentazocine versus intramuscular pentazocine, diclofenac, and paracetamol analgesics for pain relief in the first 48 h after cesarean section

Ogochukwu Obi, J. Tukur, A. Abdurrahman, I. Salisu
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Abstract

Background: Cesarean section is one of the most commonly performed operations in obstetric practice. A multimodal approach to post-cesarean pain management has been shown to be more effective than a unimodal approach, though the most effective combination and preferred route of administration are still unknown. Aim: To compare the effectiveness of rectal diclofenac sodium and intramuscular pentazocine versus intramuscular pentazocine, paracetamol, and diclofenac analgesics for pain relief in the first 48 h after cesarean section at Federal Medical Centre, Katsina. Methods: This was a prospective single-blind, randomized controlled trial, in which 120 booked women planned for cesarean section were recruited and randomly allocated to the study or control group. The study group received 100 mg rectal diclofenac sodium 12 h and intramuscular pentazocine 60 mg 6 h, while the control group received intramuscular diclofenac 75 mg 12 h, pentazocine 60 mg 6 h, and paracetamol 600 mg 8 h for the first 48 h postoperatively. Pain perception, maternal satisfaction, and preferred route of drug administration were compared between the two groups. Results: The study group had significantly lower mean visual analog scale pain scores and higher maternal satisfaction in the first 48 h (P < 0.05). There were no significant differences in the maternal and newborn side effects of the analgesics. The rectal route of drug administration was more preferred (P < 0.05). Conclusion: The study showed that rectal diclofenac sodium and intramuscular pentazocine post-cesarean section analgesic efficacy and maternal satisfaction were superior to that of intramuscular pentazocine, diclofenac, and paracetamol.
剖宫产术后48小时直肠双氯芬酸钠和肌注戊唑嗪与肌注戊唑嗪、双氯芬酸和扑热息痛镇痛的随机对照试验
背景:剖宫产是产科实践中最常见的手术之一。剖宫产后疼痛管理的多模式方法已被证明比单模式方法更有效,尽管最有效的组合和首选的给药途径仍然未知。目的:比较卡齐纳联邦医疗中心剖宫产术后48小时直肠双氯芬酸钠和肌注戊唑嗪与肌注戊唑嗪、扑热息痛和双氯芬酸镇痛的镇痛效果。方法:这是一项前瞻性单盲、随机对照试验,招募120名计划剖宫产的预定妇女,随机分配到研究组或对照组。研究组术后48 h直肠双氯芬酸钠100 mg,肌注戊唑嗪60 mg 6 h;对照组术后48 h肌注双氯芬酸75 mg 12 h,戊唑嗪60 mg 6 h,扑热息痛600 mg 8 h。比较两组产妇的疼痛感觉、产妇满意度和给药途径。结果:研究组分娩前48 h平均视觉模拟量表疼痛评分显著低于对照组,产妇满意度显著高于对照组(P < 0.05)。两种镇痛药对产妇和新生儿的副作用无显著差异。直肠给药途径优先(P < 0.05)。结论:本研究显示,剖宫产术后直肠双氯芬酸钠联合肌注戊唑嗪镇痛效果和产妇满意度均优于肌注戊唑嗪、双氯芬酸和扑热息痛。
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