Post-operative discomfort after ring or clip tubal ligation — is there any difference and do indomethacin suppositories help?

One-hundred patients undergoing Falope ring or clip laparoscopic tubal ligation were given either a placebo or a 100 mg indomethacin rectal suppository one hour preoperatively. Treatment was randomised and double-blind. Post-operative analgesic requirements and side effects were monitored. Forty-seven patients receiving indomethacin and 48 patients receiving placebo were available for analysis. Thirty-five patients in the indomethacin group required Meperidine (pethidine) analgesia (mean dose 58 mg) compared to 41 patients (mean dose 65 mg) in the placebo group. These differences were not significant. There were no significant differences in the non-narcotic analgesia given to each group, the side effects or the number requiring to stay overnight in the hospital. Analysis of the analgesic requirements of the 53 patients having clip sterilization and the 42 patients sterilized with Falope rings showed no statistical differences. This trial suggests that the immediate post-operative discomfort rates between ring and clip tubal occlusion are not different and that there is no significant benefit from the use of an indomethacin suppository pre-operatively.