Efficacy of diclofenac transdermal patch and diclofenac rectal suppository for postoperative pain management following open cholecystectomy: A single blind prospective comparative study

Abstract

Postoperative pain control is an important component of surgical patient care. Inadequate pain control in postoperative period increases mortality and morbidity to great extent. Studies have shown transdermal diclofenac is as effective as intramuscular diclofenac injection in postoperative analgesia, but a comparison of diclofenac rectal suppository and transdermal route is lacking. This research proposal intends to study and compare the effectiveness of Diclofenac transdermal patch and rectal suppository.Randomized, Single Blind, Prospective, Comparative study.ASA 1 and 2 patients scheduled for open cholecystectomy withsample size60 patients divided between group TD (transdermal patch, n=30) and RS (rectal suppository, n=30). 100 mg diclofenac epolamine patch was applied on inner aspect of left arm in TD group’s 1hr before incision Patch was changed 12hrly for 48 hrs. 100 mg diclofenac sodium was introduced per-rectally in PR group just before induction of anesthesia and repeated 12hrly for 48hrs. Each patient was monitored and data collected in PACU, PCA remote was again shown to patients and advised them to press button whenever they feel.It has been found that both the groups were comparable in their demographic distribution, in terms of age and sex. 14 readings were taken from just after OT till 48hrs from starting surgery. None of the patients in the study showed the sign or symptoms of opioid overdosing. The pain was better controlled with Diclofenac through per rectal route than the transdermal route.Considering mean rank of VAS till 6hrs after skin incision and drugs given during 1, 2 and 3 readings at 6 hr., 12 hr., 18 hr. and continue 6hrly and total drugs given till 48hrs, pain after open cholecystectomy was better controlled with diclofenac sodium rectal suppository in comparison to diclofenac epolamine patch.