Preoperative diclofenac sodium reduces postlaparoscopy pain

Abstract

Post-laparoseopy pain can increase recovery time and delay patient discharge. While previous studies have focused on the problems of nausea and vomiting, the purpose of this study was to assess the effect of diclofenac (a non-steroidal antiinflammatory drug) Krisfianstad County Council provided financial support. Ciba-Geigy, Sweden, supplied the diclofenac and placebo used in this study.Accepted for publication 5th January, 1993. Le diclofdnac produit un meilleur soulagement it 24 hres (1,0 vs 2,5, P < 0,05) et diminue le nombre de patientes qui ont besoin d'analgdsiques additionnels (7 vs 15, P < 0,05). 17 n'y a pas de difference dans Hncidence des effets secondaires. Ces donn~es suggbrent que le diclofdnac diminue la douleur postlaparoscopie et les besoins postop~ratoires d'analg~siques.In many patients post-laparoscopy pain is severe and difficult to manage. ~ In a recent study, peritoneal biopsy, performed two or three days after laparoscopy, showed peritoneal inflammation resulting from capillaries which were torn at the time that the abdomen was distended with gas. In the same study a linear relationship was found between abdominal compliance at the time of laparoscopy and the severity of postoperative pain. 2 Postoperative pain control using non-steroidal antiinflammatory drugs (NSAIDs) may reduce peritoneal inflammation and consequently reduce the pain. The purpose of this study was to assess the analgesic efficacy of rectally administered diclofenac before surgery on postoperative pain following gynaecological laparoscopy. MethodsAfter approval of the protocol by the Ethical Committee of the Faculty of Medicine of the University of Lund, informed written consent was obtained from 49 women, ASA I-II, who required laparoscopic surgery. If laparotomy was performed, the patient was excluded from the study. Each patient was allocated to one of the study groups according to a random number sequence. ProcedureAll patients underwent laparoscopy with general anaesthesia. Sixty minutes before induction of anaesthesia meperidine 75 mg (Petidin, Kabi, Sweden) was given On. At the same time diclofenac sodium 50 mg (Voltaren/ Voltarol, Ciba-Geigy, Basle) or placebo was administered pr to the patient in a randomized double-blind manner. The ECG monitored continuously. After glycopyrrolate 3 ~g" kg -I (Robinul, Robins, UK) anaesthesia was induced with fentanyl, 1 ~tg. kg -I (Leptanal, Janssen Pharmaceutica, Belgium), followed by thiopentone, 4-5 mg. kg -1 (Pentothal, Abbot, US). Tracheal intubation CAN J ANAESTH 1993 / 40:5 / pp406--8

The comparison of preemptive analgesic effects of curcumin and diclofenac

“…Woolf et al (24) showed no difference with preoperative diclofenac from postoperative diclofenac in patients undergoing laparascopic tubal ligation. However, Buggy et al (25) and Gillberg et al (26) demonstrate that preoperative administration of ketorolac, piroxicam and diclofenac did reduce postoperative pain in patients undergoing laparoscopy. Our fi ndings support these results as well.…”

Pre-Emptive Intravenous Diclofenac Sodium for Laparoscopic Tubal Ligation

“…13 Gillberg and collegues also stated that diclofenac sodium 50mg given per rectally 1 hour before the procedure showed significant decrease in both pain intensity and requirement of additional analgesic postoperatively. 14 The mean ambulation time (hrs) in preemptive group was significantly earlier compared to the intraoperative group. (table3, figure 3B) thus achieving the target of earlier discharge.…”

“…6 Bilateral rectus sheath block, local anaesthetic infiltration directly to the fallopian tube or into the mesosalpinx have been used with moderate success. [14][15][16][17][18][19][20] However most of them rely on surgical linfiltration methods. Laparoscopic tubal ligations have been performed as a day care surgery with rapid turnovers in a busy gynaecological set up where quick in and out is the norm and requirement .…”

Effects of peroperative intravenous paracetamol and lornoxicam for lumbar disc surgery on postoperative pain and opioid consumption: A randomized, prospective, placebo-controlled study

“…Similarly, Toygar et al [8] were also unable to show an early postoperative analgesic effect with paracetamol for lumbar disc surgery patients. O'Hanlon et al, [19] Zor et al, [23] and Gilberg et al [24] determined that the first analgesic requirement of preemptive groups occurred later, their pain scores were lower, opioid consumption was little and postoperative analgesic quality was better in their studies in which they evaluated preemptive and postoperative NSAIDs. The longer duration for first analgesic request that we observed in Group L might be a consequence of pre-emptive lornoxicam's extending the analgesic effect in the post-operative period.…”