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Diclofenac sodium versus fentanyl for analgesia in laparoscopic sterilization.

Abstract：

:The effectiveness of an anaesthetic technique employing diclofenac sodium as an analgesic given preoperatively by intramuscular injection was compared against one employing intravenous fentanyl in patients undergoing laparoscopic sterilization. Postoperative pain was marked and both drugs provided partial relief only. Patients in the diclofenac group had pain scores that were initially higher than those in the fentanyl group and the difference between the groups was statistically significant (P < 0.02). Patients in the diclofenac group who received postoperative supplemental morphine analgesia recorded lower pain scores at 30 min than comparable patients in the fentanyl group (P < 0.03). These findings suggest that neither drug provides sufficient analgesia for laparoscopic sterilization when given as a sole analgesic. Investigation of a combined analgesic technique employing morphine and a non-steroidal anti-inflammatory drug is warranted. :Pain is a marked feature of laparoscopic tubal ligation. Effective postoperative analgesia would make the procedure more acceptable for day-case anaesthesia. An analgesic suitable for day-case anaesthesia needs to provide analgesia without prolonging recovery or producing other adverse events such as nausea and vomiting. In the attempt to identify such an analgesic, the authors obtained informed oral consent from 80 patients to compare the effectiveness of diclofenac sodium versus fentanyl for analgesia in laparoscopic sterilization. Both drugs were administered preoperatively by intramuscular injection to the gluteal region, diclofenac sodium to 40 women and fentanyl to the remaining 40. Patients were subsequently sterilized by application of Falope rings to the Fallopian tubes. Postoperative pain was marked and both drugs provided only partial relief. Patients in the diclofenac group had pain scores which were initially higher than those in the fentanyl group and the difference between the groups was statistically significant. Patients in the diclofenac group who received postoperative supplemental morphine analgesia recorded lower pain scores at 30 minutes than comparable patients in the fentanyl group. Findings suggest that neither drug provides sufficient analgesia for laparoscopic sterilization when given as a sole analgesic. This warrants the investigation into a combined analgesic technique employing morphine and a nonsteroidal anti-inflammatory drug.

journal_name

Acta Anaesthesiol Scand

journal_title

Acta anaesthesiologica Scandinavica

authors

Grace D,Milligan KR,Loughran PG,McCaughey W

doi

10.1111/j.1399-6576.1994.tb03904.x

subject

Has Abstract

pub_date

1994-05-01 00:00:00

pages

342-5

issue

eissn

0001-5172

issn

1399-6576

journal_volume

pub_type

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Diclofenac sodium versus fentanyl for analgesia in laparoscopic sterilization.