Rashid M, Jaruidi H M
Department of Obstetrics & Gynecology, Security Forces Hospital, PO Box 3643, Riyadh 11481, Kingdom of Saudi Arabia.
Saudi Med J. 2000 Feb;21(2):145-9.
To determine whether the prophylactic use of rectal diclofenac sodium produces effective analgesia after cesarean section.
A randomized single blind controlled trial. The study period was from September 1997-April 1998. Forty patients undergoing both emergency and elective cesarean section were studied, with 20 patients in each arm. The study group received 100 mg rectal diclofenac immediately after cesarean section followed by 50 mg at 12 hours and 100 mg at 36 hours after the surgery. The control group did not receive any diclofenac suppositories.
The results showed that the visual analogue score for pain in the study group was significantly less at 12, 18 and 24 hours after surgery (P <0.05). The amount of pethidine consumed was also significantly less (P <0.05) with 28 injections consumed in the study group as compared with 52 in the control group (each pethidine injection = 100 mg). The incidence of sedation and constipation was significantly less (P<0.05) in the study group. However, the incidence of nausea and post-operative pyrexia was comparable in the 2 groups.
Rectal diclofenac provides effective analgesia when given after cesarean section. It also reduces the patients opioid requirements with a corresponding reduction in the opioid related side-effects.
确定剖宫产术后预防性使用直肠双氯芬酸钠是否能产生有效的镇痛效果。
一项随机单盲对照试验。研究时间为1997年9月至1998年4月。对40例行急诊和择期剖宫产的患者进行研究，每组20例。研究组在剖宫产术后立即直肠给予100mg双氯芬酸钠，术后12小时给予50mg，术后36小时给予100mg。对照组未接受任何双氯芬酸栓剂。
结果显示，研究组术后12、18和24小时的视觉模拟疼痛评分显著更低（P<0.05）。研究组哌替啶的消耗量也显著更少（P<0.05），研究组注射了28次哌替啶，而对照组为52次（每次哌替啶注射量=100mg）。研究组镇静和便秘的发生率显著更低（P<0.05）。然而，两组恶心和术后发热的发生率相当。
剖宫产术后给予直肠双氯芬酸钠可提供有效的镇痛效果。它还减少了患者对阿片类药物的需求，并相应减少了与阿片类药物相关的副作用。
