A pilot study of the efficacy of diclofenac suppository and intramuscular morphine for relieving the post-cesarean pain

Abstract

A proper post-cesarean section (CS) pain relieving method results in early mobilization and better early maternal–fetal interaction. Many different methods have already been suggested for analgesic purposes after CS delivery. The known standard method is the intramuscular injection of morphine; however, in our medical center, administration of the diclofenac suppository has been the practice of choice. The aim of this study is to compare the efficacy of the two methods on relieving the post-CS pain. In a clinical trial, 120 parturient women were recruited after CS in Taleghani Hospital of Tabriz during an 18-month period (2006 to 2007). They were randomized into two equal groups: Receiving either diclofenac suppository (3*100 mg in 24 h post-surgery) (group D) or intramuscular (IM) morphine (3*10 mg in 24 h post-surgery) (group M). The pain level was evaluated according to Visual Analogue Score (VAS) on 8, 16 and 24 h post-cesarean for each patient. The mean age (26.98 ± 5.85 vs. 27.15 ± 5.08 years), gravidity (2.13 ± 1.27 vs. 2.00 ± 1.15), parity (0.95 ± 1.05 vs. 0.87 ± 0.98 years), and the gestational age (38.98 ± 1.43 vs. 38.35 ± 2.55 weeks) were compared in groups D and M respectively (p > 0.05). The mean pain severity score was significantly lower in group D for every three readings (p < 0.001). The mean reduction of the pain score was also higher in the same group (p < 0.05). No major complications were observed in either group. The current study showed that the diclofenac suppository is considerably more efficient than IM morphine in relieving post-CS pain. Key words: Cesarean section, pain, morphine, diclofenac.