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Year : 2015  |  Volume : 20  |  Issue : 2  |  Page : 2-11

Diclofenac and pentazocine versus pentazocine alone for post-operative analgesia in cesarean section

1 Department of Obstetrics and Gynecology, Faculty of Medicine, NnamdiAzikiwe University, Nnewi Campus, Nigeria
2 Department of Obstetrics and Gynecology, NnamdiAzikiwe University Teaching Hospital, Nnewi, PMB 5025, Nnewi, Nigeria
3 Department of Obstetrics and Gynaecology, Madonna University Teaching Hospital, Elele, Nigeria

Correspondence Address:
George Uchenna Eleje
Department of Obstetrics and Gynecology, Faculty of Medicine, NnamdiAzikiwe University, Nnewi Campus
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Source of Support: None, Conflict of Interest: None

DOI: 10.4314/jcm.v20i2.2

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Background: Postoperative pain remains one of the greatest concerns during and after cesarean section (CS). Various regimens have been used for post-cesarean pain control including opioids but unfortunately, the intolerability and addictive tendencies of opioids have reduced their acceptability necessitating other more effective and well tolerated alternative. Objective: To determine the effectiveness of diclofenac sodium combined with pentazocine versus pentazocine alone in reducing post-operative pain after CS. Methods: This was an open-label, quasi-randomized clinical trial of 67 women that underwent CS and received either duplet (administration of diclofenac sodium tablets rectally every 12 hours and pentazocine intramuscularly every 6 hours) or single (pentazocine alone) pain treatment, all for 48 hours. Primary outcome measure was visual analogue pain score. Secondary outcome measures were women's satisfaction, commencement of oral sips, mobilization, breastfeeding and return of bowel function including maternal adverse effects. Statistical analysis involved descriptive and inferential statistics at 95% level of confidence using the Epi Info 2008 version 3.5.1. P ≤ 0.05 was considered statistically significant. Analysis was by intention-to-treat. Results: Women receiving duplet treatment, as compared to pentazocine only, experienced less pain (p < 0.001; OR=15.56; 95% CI=4.03 to 64.94), greater good patient' satisfaction (p<0.001; OR=21.54; 95% CI=5.29 to 96.43), and mobilization at less than 24 hours of surgery (p<0.001; OR=116.25; 95% CI=16.52 to1125.66). No significant difference was seen in initiation of oral sips, breastfeeding, return of bowel function and maternal adverse effects (p>0.05). Conclusion: Diclofenac combined with pentazocine significantly reduced pain, increased patient' satisfaction and earlier mobilization during post-cesarean period compared to pentazocine alone.

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