Comparison of Postoperative Outcome with Diclofenac Rectal Suppositories Versus Intramuscular Diclofenac in Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Objective: The aim of this study was to compare postoperative outcome with diclofenac rectal suppositories versus intramuscular diclofenac in patients undergoing laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial. Settings: General surgery Department, Khawaja Muhammad Safdar Medical College Sialkot & Allied Hospital Faisalabad Pakistan. Duration: 2 year from May 2017 to April 2019. Methodology: After informed consent, 200 patients scheduled for laparoscopic cholecystectomy were randomized into two groups. Group-A got diclofenac sodium rectal suppository at time of induction of anesthesia and Group-B were given IM Diclofenac for postoperative pain relief. Assessment of pain was done using Visual Analogue Scale (VAS) by an observer which will be graded ruler ranging from 0-10 showing the minimal and maximum pain score respectively. The score was assessed post operatively at recovery time 6, 12 and 24 hours. Activity score was checked at 8, 12 & 24 hours postoperatively. Data was collected for pain & mobility through specially designed Performa. Results: Demographic characteristics, intraoperative and postoperative hemodynamics of the patients were similar between groups. Postoperative VAS were lower at all-time points in Group -A. Mean VAS was 6.41(SD 0.89), 4.03 (SD 0.92), 2.16 (SD 0.84) in group A as compared to 7.78 (SD 0.83), 5.86 (SD 0.92), 4.4 (SD 1.33) in group B after 6hr, 12 hr. & 24 hr. respectively. Mean activity score was 3.28 (SD 0.61), 1.8(SD 0.79), 1.1(SD 0.36) in group A and 4.35 (SD 0.63), 3.31 (SD 0.83), 2.85 (SD) in group B after 8 hr., 12 hr. and 24 hr. respectively. Conclusion: In patients undergoing laparoscopic cholecystectomy, application of diclofenac sodium rectal suppository at time of induction of anesthesia is more effective than IM diclofenac sodium and can be preferred in postoperative pain treatment.