Abstract
Post-laparoscopy pain can increase recovery time and delay patient discharge. While previous studies have focused on the problems of nausea and vomiting, the purpose of this study was to assess the effect of diclofenac (a non-steroidal antiinflammatory drug) in the treatment of post-laparoscopy pain. Diclofenac (50 mg) or placebo was administered pr randomly and double-blind, prior to induction of anaesthesia, to 46 women. Pain intensity was assessed by the patient using a visual analogue scale 1, 12 and 24 hr after surgery. Postoperative analgesic requirements and side effects were also studied. Diclofenac resulted in better pain relief at 24 hr (1.0 vs 2.5, P < 0.05) and reduced the number of patients who needed additional postoperative analgesics (7 vs 15, P < 0.05). There was no difference in the incidence of side effects. These data suggest that diclofenac reduces post-laparoscopy pain and postoperative analgesic requirements.
Résumé
La douleur postlaparoscopique ralentit la récupération et retarde le congé. Alors que des études antérieures portaient sur les phénomènes de nausées et de vomissements, l’objectif de cette étude est d’évaluer les effets du diclofénac (un antiinflammatoire non-stéroïdien) sur la douleur postlaparascopie. Le diclofénac 50 mg ou un placébo sont administrés à 46 femmes au hasard et à double insu par la voie rectale avant l’induction de l’anesthésie. L’intensité de la douleur est évaluée par la patiente à l’aide d’une échelle visuelle analogique 1 hre, 12 et 24 hres après la chirurgie. Les besoins analgésiques postopératoires et les effets secondaires sont aussi étudiés. Le diclofénac produit un meilleur soulagement à 24 hres (1,0 vs 2,5, P < 0,05) et diminue le nombre de patientes qui ont besoin d’analgésiques additionnels (7 vs 15, P < 0,05). Il n’y a pas de différence dans l’incidence des effets secondaires. Ces données suggèrent que le diclofénac diminue la douleur postlaparoscopie et les besoins postopératoires d’analgésiques.
Article PDF
Similar content being viewed by others
References
Narchi P, Lecoq G, Fernandes H, Benhamou D. Intraperitoneal local anesthetics and scapular pain following daycase laparoscopy. Anesthesiology 1990; 73: A5.
Comyn DJ. Minimising pain after laparoscopy. 9th World Congress of Anesthesiologists, Washington D.C. May 1988; A0004.
Huskisson EC. Measurement of pain. Lancet 1974; II: 1127–31.
Dodson ME. Laparoscopy and suxamethonium muscle pain, (Corresp.). Br J Anaesth 1978; 50: 84.
Bailey PL, Streisand JB, Pace NL, et al. Transdermal scopolamine reduces nausea and vomiting after outpatient laparoscopy. Anesthesiology 1990; 72: 977–80.
Tripple GE, Holland MS, Hassanein K. Comparison of droperidol 0.01 mg/kg and 0.005 mg/kg as a premedication in the outpatient for laparoscopy. Journal of the American Association of Nurse Anesthetists 1989; 57: 413–6.
Rainsford KD, Velo GP (Eds). Side-Effects of AntiInflammatory Drugs. Lancaster: MTP Press Ltd. 1985; 55–72.
Hodsman NBA, Burns J, Blyth A, Kenny GNC, McArdle CS, Rotman H. The morphine sparing effects of diclofenac sodium following abdominal surgery. Anaesthesia 1987; 42: 1005–8.
Moffat AC, Kenny GNC, Prentice JW. Postoperative nefopam and diclofenac. Anaesthesia 1990; 45: 302–5.
Valanne J, Korttila K, Ylikorkala O. Intravenous diclofenac sodium decreases prostaglandin synthesis and postoperative symptoms after general anaesthesia in outpatients undergoing dental surgery. Acta Anesthesiol Scand 1987; 31: 722–7.
Lindgren U, Djupsjö H. Diclofenac for pain after hip surgery. Acta Orthop Scand 1985; 56: 28–31.
Carlborg L, Lindoff C, Hellman A. Diclofenac versus pethidine in the treatment of pain after hysterectomy. Eur J Anaesthesiol 1987; 4: 241–7.
Comfort VK, Code WE, Rooney ME, et al. Naproxen premedication reduces postoperative tubal ligation pain. Can J Anaesth 1992; 39: 349–52.
Pandit SK, Kothary SP, Lebenbom-Mansour M, Levy L, Randel GI, Mathei M. Failure of ketorolac to prevent severe postoperative pain following outpatient laparoscopy. Anesthesiology 1991; 75: A33.
Nuki G. Pain control and the use of non-steroidal analgesic anti-inflammatory drugs. Br Med Bull 1990; 46: 262–78.
Dahl JB, Kehlet H. Non-steroidal anti-inflammatory drugs: rationale for use in severe postoperative pain. Br J Anaesth 1991; 66: 703–12.
Author information
Authors and Affiliations
Additional information
Kristianstad County Council provided financial support. Ciba-Geigy, Sweden, supplied the diclofenac and placebo used in this study.
Rights and permissions
About this article
Cite this article
Gillberg, L.E., Harsten, A.S. & Ståhl, L.B. Preoperative diclofenac sodium reduces postlaparoscopy pain. Can J Anaesth 40, 406–408 (1993). https://doi.org/10.1007/BF03009507
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03009507