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Correspondence to Author: Geresu Gebeyehu^1*, Selamawit Shiferaw¹ 

¹Department of Anesthesia, School of Medicine, Addis Ababa University, Addis Ababa Ethiopia

DOI: 10.52338/jocogr.2024.4256

Abstract:

Background: A significant proportion of patients suffer moderate to severe pain after surgery despite wide pain management protocols. This study evaluated the effectiveness of diclofenac as a preemptive analgesic for postoperative pain management in patients that underwent abdominal hysterectomy under general anesthesia.
Methods A prospective cohort study was conducted on 86 ASA I and II women aged >18 years old and undergoing abdominal hysterectomy from March to August 2020 Tertiary Hospital, Ethiopia. The participants were recruited into this prospective observational cohort study. Study participants were grouped as group D (who took preemptive IV diclofenac 75mg) and group C (who did not or control) based on whether or not IV diclofenac was given 30 minutes to one hour prior to the surgical incision. The pain severity, total analgesic consumption, first analgesic request time, and incidence of nausea and vomiting within 24 hours postoperatively were compared between the two groups. Student’s t-test and Mann-Whitney U test were used for analyzing numeric data. Categorical variables between the groups were analyzed using the chi-square test. P-values 0.05 were considered statistically significant.
Results: Median pain score in the early postoperative period (in the 2nd, 4th, and 8thhr) was significantly lower in the diclofenac group (0.007, 0.004, 0.001, 0.261, and 0.796 respectively). The mean first analgesic request time between the groups was not significantly different (p>0.05). Total postoperative analgesic consumption was significantly lower in the diclofenac group (p=0.0006). The occurrence of nausea and vomiting was comparable between the two groups (p>0.05).
Conclusion and Recommendation: Preemptive diclofenac significantly reduced postoperative pain severity and total analgesic consumption and associated with fewer side effects in women undergoing abdominal hysterectomy. We recommend all anesthesia providers to use 75 mg IV diclofenac 30 min to 1 hour prior to surgical incision to minimize postoperative pain severity.

Citation:

Geresu Gebeyehu.Preemptive Analgesic Effect Of Intravenous Diclofenac In Women That Underwent Abdominal Hysterectomy Under General Anesthesia In A Limited Resource Settings: An Observational Cohort Study. Journal of Clinical Obstetrics and Gynecology Research 2024.