Manoranjan Ujjaini Dhananjayappa1, Nikhil Suresh2, Durganna Timappa3
Both rectal diclofenac and paracetamol are commonly used to treat acute postoperative, but combining them to improve the quality of analgesia is controversial. This study aimed to detect whether the preoperative combined administration of rectal diclofenac and paracetamol is superior to injectable tramadol alone, is effective in postoperative pain management. METHODS 57 patients were randomly assigned to receive the suppository 1 hr. prior to surgery. In the first 24 hrs. postoperatively, pain was assessed using the visual analogue pain scale (VAS). If the patients experienced a pain score of 5 or more, tramadol 50 mg IV was given. The total dose of tramadol and number of doses required were recorded. Patients who received the rectal diclofenac-paracetamol combination experienced a lower pain scale and a decreased need for tramadol compared with those receiving tramadol alone. RESULTS The overall VAS score and consumption of injectable tramadol was lower in the group receiving the rectal suppository. The mean VAS score in group 1 at 4, 8 and 24 hours was lower than those in group 2, this difference was statistically significant (p<0.000). CONCLUSIONS Patients receiving the rectal diclofenac-paracetamol combination experienced significantly a lower pain as compared with patients getting only injectable analgesics. The need for injectable analgesics was also found to be reduced in the immediate postoperative period in the patients receiving rectal suppository.
