Diclofenac and Ketoprofen for Pain Treatment After Elective Casesarean Section

Abstract

We have studied the effect of a constant infusion of diclofenac 150 mg/24 h, ketoprofen 200 mg/24 h or placebo on postoperative pain after elective Caesarean section performed under spinal or extradural block in 90 patients in a prospective, randomized and double-blind study. During the first 24 h after operation, patients in the treatment groups were more comfortable than the placebo group (P < 0.005); the diclofenac group needed a mean of oxycodone 21.6 mg/24 h and the ketoprofen group 21.2 mg/24 h, compared with 38.3 mg/24 in the placebo group (P < 0.001); the mean time to the first injection of oxycodone was 270.5 min in the diclofenac group, 270.2 min in the ketoprofen group and 161.2 min in the placebo group (P < 0.001). During the first 24 h after operation, the temperature increased in the control group by 0.7 degrees C compared with 0.1 degrees C in the diclofenac group and 0.3 degrees C in the ketoprofen group. One patient in the diclofenac group was eliminated from the study because of uterine relaxation during the first 30 min after start of the drug infusion; this improved after cessation of diclofenac and infusion of sulprostone. There were no other serious side effects.

The effect of diclofenac and ketoprofen on halothane MAC in rabbit

“…The doses of diclofenac and ketoprofen in the present study were choosen according to the recommended maximum doses; these doses showed to be equianalgesic also in a previous clinical study [15]. The following considerations led us to use the 3 dosages employed in our study: (1) Small doses of NSAIDs (subdose 1) inhibit the synthesis ofthromboxane A2 but do not interfere with the action of other enzymes, e.g.…”

Intravenous tenoxicam reduces uterine cramps after Cesarean delivery

“…Studies have shown that the analgesic efficacy of NSAIDs could reduce opioid consumption after Cesarean delivery. [17][18][19] However, wound pain and uterine contraction pain are qualitatively different. Our study demonstrates that the analgesic effect of iv tenoxicam can reduce the intensity of postpartum uterine contraction pain.…”

“…20,21 Reports have shown the analgesic effect of iv ketoprofen and diclofenac for the treatment of pain after Cesarean delivery. 17 However, the half-life of ketoprofen is five to six hours and that of diclofenac is 1.5 hr, 22 indicating that repeated doses may be needed. Tenoxicam specifically inhibits prostaglandin synthetase and has a long plasma half-life (75 hr) allowing once daily dosage.…”

Effect of small dose intermittent IV pethidine in combination with diclofenac for post operative pain relief

“…So it is not always applicable or without side effect and require skill manpower. Now a days another combined analgesic method, opioid with NSAIDs is used to manage postoperative pain 9 with the aim of reduction of opioid doses. 8 Combined analgesic techniques are also popular for postoperative pain management in this country without definitive effective method of drugs administration.…”

“…In our setting among the NSAIDs diclofenac sodium is commonly used, easily available and very cheap and equianlgesic with ketoprofen, ketorolac and piroxicam 9,10 . Among the opioids pethidine is one which is supplied to the Government hospital though not easily procurable from the open market.…”