Preoperative or postoperative diclofenac for laparoscopic tuballigation

Abstract

We have compared the analgesic effects of diclofenac given before operation or immediately after operation in a randomized, double-blind, double-dummy study of 40 healthy female patients undergoing laparoscopic tubal ligation. Group 1 patients received diclofenac 75 mg as a 3-ml i.m. injection 1-2 h before operation and normal saline 3 ml i.m. immediately after surgery. Group 2 patients received normal saline 3 ml i.m. before operation and diclofenac 75 mg i.m. immediately after surgery. Outcome measures were patients' perception of pain on a visual analogue scale (VAS), verbal response scale (VRS), the number of patients who required postoperative morphine, time to first postoperative morphine injection and total dose of morphine given. VAS at 30 min and at 1, 3 and 6 h after operation were, respectively (median, interquartile range) 4.5 (2.3-6.0) vs 5.3 (2.8-7.8); 3.3 (2.3-5.0) vs 4.4 (3.0-5.8); 1.4 (0-2.3) vs 1.9 (0.8-3.0); 0.5 (0-1) vs 0.7 (0-1.3), (ns). VRS at 1 and 3 h after operation were, respectively, (median, interquartile range) 2.2 (1.5-3.0) vs 2.7 (2.0-4.0) and 0.8 (0-1.3) vs 0.9 (0-1.5) (ns). Sixteen patients in group 1 compared with 17 in group 2 required postoperative morphine. Time to first morphine administration and dose given were, respectively, (median, interquartile range) 50.6 (39-60) min vs 35.7 (20-49) min (P = 0.1) and 9.0 (5-10) mg vs 9.5 (7.5-10) (P = 0.9).(ABSTRACT TRUNCATED AT 250 WORDS)

Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy

“…A recent report by Rømsing et al 7 also demonstrated that, for tonsillectomy, preoperative intravenous ketorolac reduced the postoperative use of fentanyl more than postoperative administration. In contrast, Buggy et al 8 showed that administration of diclofenac i m prior to laparoscopic tubal ligation produced no additional benefit compared with postoperation administration. In our study, preoperative administration of flurbiprofen reduced postoperative pain more than postoperative administration during the 72 hr period monitored, not only at rest, but also on coughing.…”

“…5 The preemptive efficacy of NSAIDs is controversial: not all studies have reported benefit. [5][6][7][8] We investigated whether flurbiprofen iv, given in a preemptive manner, reduce postoperative pain after abdominal hysterectomy .…”

Preemptive Use of Etofenamate in Laparoscopic Cholecystectomy: A Randomized, Placebo-Controlled, Double-Blind Study

“…The meta-analysis showed that VAS scores in eight of the nine study arms reported a significant benefit for NSAIDs versus placebo and also reported that three study arms all reported a significant benefit for systemic NSAIDs versus placebo according the first analgesic request and use of supplementary analgesics. Conversely there are other recent studies showed that some NSAIDs have no preemptive effect in different surgical procedures (16)(17)(18).…”

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.…”