The Effects of Either Diclofenac Suppository, Intravenous Acetaminophen or their Combination on the Severity of Postoperative Pain in Patients Undergoing Spinal Analgesia during Cesarean Section.

Background: Various medications such as opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are used to alleviate discomfort following caesarean surgery. Particular attention has been paid to NSAIDs due to complications of opioids, and doctors use these medications as useful analgesics to manage various forms of pain. This research was conducted to evaluate the effect of either diclofenac suppository, intravenous acetaminophen or their combination on reduction of the severity of postoperative pain in patients undergoing caesarean section spinal analgesia. Methods: This was comparative prospective interventional clinical study in Zagazig University Maternity Hospital during the period from August 2017 to December 2017. Includes 48 patients undergoing caesarean section. Patients were randomly divided (by alternation) into three groups of 16 patients, group A: 100 mg diclofenac suppository, group B: 1000 mg acetaminophen by intravenous infusion injection in 200 ml of 0.9 percent saline, group C: 100 mg diclofenac suppository and 500 mg intravenous acetaminophen. All patients underwent full clinical assessment and 24-hour pain follow-up. At the end of the surgery, pain severity was measured on a VAS scale at various intervals. Results: The lowest mean pain severity was found in the combination group during the study and the highest was observed in the diclofenac group. There was significant difference of times of additional doses of analgesia which high in group diclofenac then group acetaminophen and the least times detected at combination group. Conclusion: The combination of acetaminophen and diclofenac has stronger and longer analgesic effects than the single use of each drug. [ABSTRACT FROM AUTHOR]