Diclofenac Eases Postoperative Pain And compares favourably with pethidine in women undergoing hysterectomy

A double-blind study was designed to compare the efficacy and tolerability of diclofenac with those of pethidine and placebo in postoperative pain , 63 women were randomised to receive 1M diclofenac 75mg (n = 22) , 1M pethidine 50mg (n = 21) or 1M placebo (n = 20) within 30 min of the completion of laparotomy for total or subtotal hysterectomy, A second injection of the same test drug was allowed ~ 30 min after the first if requested by the patient and , if pain relief was not achieved, hydromorphone 2mg was administered after a further 30 minutes,

The median duration of pain relief was 12, 4 and 2 hours in the diclofenac-, pethidine- and placebo­treated groups, respectively (significant between diclofenac and pethidine and between diclofenac and placebo), After the 12-hour observation period 14, 6 and 1 patient receiving diclofenac, pethidine and placebo, respectively , had not yet requested a second injection Hydromorphone was requested by 2, 6 and 13 patients, respectively , Time to first flatus passage and time to first bowel movement were not significantly different between treatment groups, Adverse effects included apnoea (pethidine, n = 1) and mild effects of vertigo, muscle pain , drowsiness and nausea, reported by 4, 7 and 8 patients receiving diclofenac, pethidine and placebo, respectively ,

'In conclusion, this study indicates that diclofenac is an effective analgesic when given after hysterectomy, and is an alternative to opiates.' Carl borg L. Llndoff C , Hellman A European Journal of AnaeSlheslology 4: 241~24 7 , Jul 1987

0156-2703/88/ 0109-0013/ 0$01.00/0 © ADIS Press INPHARMA · 9 January 19BB 13