Intravenous Diclofenac Sodium Versus Ibuprofen as A Component of Multimodal Post Operative Analgesic Plan After Caesarean Section: A Double-Blinded Randomised Comparative Study

Document Type : Original Article

Authors

1 Department of Anesthesia, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

2 Department of Anesthesia, Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt.

3 Department of Clinical Pharmacology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Abstract

Background: Postoperative pain has a significant direct relationship to morbidity of female patients after caesarean section. Adequate post caesarean section pain management is fundamental.  
Objectives: To compare the postoperative analgesic effect of both ibuprofen and diclofenac sodium on pain score, rescue opioid requirement and patient satisfaction in female patients after caesarean section.
Patients and methods: This prospective, randomised, double-blind comparative study was conducted over a period of eight months in Kafr Elsheikh University Hospital, obstetric unit. The study included any American Society of Anaesthesiologists [ASA] physical status II female patients aged 18–40 years who were scheduled for elective and emergency caesarean section under spinal anaesthesia. Patients were randomly allotted into two groups: Group D [intravenous diclofenac group] and Group I [intravenous ibuprofen group].
Results: First request of analgesics, total opioid consumption and VAS showed no significant differences between two groups except after 4hours and 8 hours postoperatively which showed significant decrease in diclofenac group than ibuprofen group. Also patient satisfaction was higher in Diclofenac group. There was increase in bleeding tendency [APTT, BT, and HB results] and abnormal abdominal bleeding attacks in diclofenac group.
Conclusion: Diclofenac decreases postoperative pain with higher potency than ibuprofen but unfortunately with more tendency to gastrointestinal complications and bleeding tendency.

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