A comparative evaluation of efficacy and safety of the combination of piroxicam with tramadol versus pentazocine in post-cesarean pain management

Abstract

Background: Acute pain management enhances the overall quality of life for individuals having cesarean sections. Although it is a basic human right, pain treatment following a cesarean section lacks a gold standard. Multimodal analgesia is now recommended to aid recovery and mitigate the adverse effects of strong pain-relieving medications like opioids. Multimodal analgesic therapy, with the goal of obtaining synergistic or additive analgesia with fewer side effects, is by combining lesser amounts of each drug with different mechanisms of action. Aims and Objectives: The objective of the study was to compare the efficacy and safety of the combination of piroxicam with tramadol versus pentazocine in post-cesarean pain management. Materials and Methods: Following cesarean section after skin closure, cases were randomly assigned into two groups of thirty cases each. Group A was administered tramadol 100 mg+piroxicam 20 mg and Group B received pentazocine 30 mg+piroxicam 20 mg by intramuscular injection. Diclofenac 75 mg served as the rescue pain relief medication. The main focus was pain control, evaluated using the Visual Analog Scale (VAS). Secondary outcomes included sedation levels and the duration until additional pain relief was required. The safety profile of the medications was assessed by monitoring adverse drug reactions. Statistical analysis involved methods such as student’s t-test, analysis of variance, and post hoc testing. Results: Both the groups were comparable and statistically significant in VAS, time to rescue analgesia, and mean sedation score. Conclusion: The combination of piroxicam with tramadol versus pentazocine is effective and considered as an acceptable method of pain relief after cesarean delivery.