This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lim, N. L. S. H. Articles by Xingyi Pan, A. Search for Related Content PubMed PubMed Citation Articles by Lim, N. L. S. H. Articles by Xingyi Pan, A.

Single dose diclofenac suppository reduces post-Cesarean PCEA requirements

Noelle Louise Siew Hua Lim, MBBS M Med (anaes)^*, Wai Kit Lo, MBBS M Med (anaes), Jin Long Chong, MBBS M Med (anaes) and Alan Xingyi Pan, MBBS

^* From the Department of Anaesthesia Surgical Intensive Care Changi General Hospital, and the
Department Of Anaesthesia Kandang Kerbau Women's Children's Hospital Singapore.

Address correspondence to: Dr. Noelle Louise Siew Hua Lim, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore. Phone: (65)8503831; Fax: (65)2601693; E-mail:nllsh{at}singnet.com.sg

Purpose: To assess the analgesic efficacy of administering, immediately after surgery, a single dose of diclofenac (100 mg suppository) to women who had undergone lower segment Cesarean section (LSCS) under combined spinal-epidural anesthesia, and received post-operative patient-controlled epidural analgesia (PCEA) with ropivacaine 0.2% and fentanyl 2 µg•ml^–1.

Methods: Forty-eight ASA physical status I or II term parturients scheduled for elective LSCS under regional anesthesia were enrolled into this randomised double-blind study. The patient-controlled epidural analgesia device was programmed to deliver a bolus of 4 ml of local anesthetic mixture with a lockout period of ten minutes and an hourly limit of 12 ml. There was no baseline infusion. The study commenced upon the patient's first demand for analgesia post-operatively and the patients were assessed at one, six, 12 and 24 hr post-operatively for pain scores on movement, dermatomal level of sensory blockade, degree of motor blockade and volume of local anesthetic used. At conclusion of the study, patients' satisfaction scores were recorded.

Results: The two groups of patients were similar demographically. Patients who received a diclofenac suppository used 52.8 ± 17.8 ml of local anesthetic mixture while those who did not, used 74 ± 25 ml (P <0.005). Pain scores and satisfaction scores did not differ significantly between the groups.

Conclusion: A single administration of 100 mg diclofenac suppository is effective in reducing post-Cesarean epidural local anesthetic/opioid requirements by 33% for the first 24 hr post-operatively.

This article has been cited by other articles:

				S. Bewley Getting to the bottom of evidence based medicine BMJ, April 5, 2008; 336(7647): 764 - 764. [Full Text]

				B. Carvalho, L. Chu, A. Fuller, S. E. Cohen, and E. T. Riley Valdecoxib for postoperative pain management after cesarean delivery: a randomized, double-blind, placebo-controlled study. Anesth. Analg., September 1, 2006; 103(3): 664 - 670. [Abstract] [Full Text] [PDF]

				B. Biccard Ropivacaine is not the S-isomer of bupivacaine Can J Anesth, December 1, 2001; 48(11): 1170 - 1171. [Full Text] [PDF]