Effect of diclofenac suppository on tramadol consumption in posthysterectomy pain

Department of Anaesthesia, The Aga Khan University Hospital, Karachi.
Journal of the College of Physicians and Surgeons--Pakistan: JCPSP (Impact Factor: 0.35). 10/2008; 18(9):533-7.
Source: PubMed


To determine reduction in dose of tramadol and side effects in posthysterectomy patients on addition of diclofenac on rectal suppository.
Randomized double blinded placebo controlled study.
The Aga Khan University Hospital, Karachi, Pakistan, from August 2004 to January 2006. Methodology: Seventy ASA I and II females, aged 20 and above, who underwent elective abdominal hysterectomy, were included in this study. Patients received identical looking suppository of either 100 mg diclofenac sodium or placebo after induction of anaesthesia and then 12 hourly for 24 hours. General anaesthesia was standardized and tramadol was given by patient controlled intravenous analgesia delivery system in the recovery.
The mean dose + SD of tramadol used in first 24 hours was found to be 317 +153 mg in the placebo-tramadol group compared to 258 +192 mg in the diclofenac-tramadol group (p = 0.15, 95% CI = 1.24 to -1.34, 6.63). Seventeen (49 %) patients in the placebo-tramadol group and 14 (40%) in the diclofenac-tramadol group used rescue analgesia (p=0.47). Sedation score was similar in both the groups and there was no difference in the incidence of nausea and vomiting and use of antiemetics between the groups.
This study did not show any reduction in tramadol consumption, given via patient controlled intravenous analgesia when rectal suppository of 100 mg diclofenac was added.

Download full-text


Available from: Fauzia Anis Khan,
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Simple and efficient way of pain management after Coronary Artery Bypass Graft (CABG) surgery is an important aspect of patients' care. Objectives: This study aimed to compare the effects of morphine and diclofenac suppositories on postoperative pain management. Patients and Methods: In this double-blinded clinical trial study, 120 patients aged 30-65 years old, undergone CABG, were equally divided into two groups of A (morphine) and B (diclofenac). All patients were anesthetized with intravenous fentanyl 10 μg/kg, etomidate 0.2 mg/kg and cisatracurium 0.2 mg/kg. Anesthesia was maintained with oxygen 50% and air 50%, propofol 50 μg/kg/min, fentanyl 1-2 μg/kg/h and atracurium 0.6 mg/kg/h. Analgesics were administered after the operation at intensive care unit (ICU) and Visual Analogue Score (VAS) was evaluated in both groups in 4-hour intervals after extubation for 24 hours. After extubation in case of VAS > 3, morphine suppository 10 mg (group A) or diclofenac suppository 50 mg (group B) was administered for patients. Results: No significant statistical relationship was found between the two groups regarding gender, age, BMI, paracetamol consumption, length of operation time, cardiopulmonary bypass pump (CPB) time, and stay time at ICU (P Value ≥ 0.05). Total dosage of used morphine was 22 ± 8.3 mg in each patient and total dosage of used diclofenac was 94 ± 32.01 mg. Average variation of VAS at measured intervals was significant (P Value ≤ 0.0001), but these variations were not significantly different when comparing the two groups (P Value = 0.023). Conclusions: Both morphine and diclofenac suppositories reduced pain significantly and similarly after CABG surgery.
    Anesthesiology and Pain Medicine 10/2014; 4(4):e19423. DOI:10.5812/aapm.19423