Thippeswamy Tejashree, Krishnaswamy Bhuvana, Bengalorkar Girish M, Mariyappa Narayanaswamy
Postgraduate, Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs University of Higher Education and Research (SDUAHER) , Tamaka, Kolar, Karnataka India .
Associate Professor, Department of Pharmacology, Sri Devaraj Urs Medical College, Sri Devaraj Urs University of Higher Education and Research (SDUAHER) , Tamaka, Kolar, Karnataka India .
J Clin Diagn Res. 2016 Nov;10(11):FC01-FC04. doi: 10.7860/JCDR/2016/21861.8785. Epub 2016 Nov 1.
Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child.
To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain.
Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia. Severity of pain was assessed using Visual Analogue Scale (VAS) and side-effects to study drugs were noted. Rescue analgesic butorphanol 2mg was administered if VAS score was more than four. Patient's satisfaction score was assessed at 12 hours post-operatively.
Mean age in piroxicam and tramadol groups were 23.32±3.43 and 22.03±2.0 years respectively. Significant reduction in pain was observed at 2, 4, 8, 12 and 24 hours in both groups (p<0.001). Pain relief was significant at 2, 4 and 8 hours in piroxicam group compared to tramadol. Twenty-one and 12 patients in tramadol and piroxicam groups received rescue analgesic respectively. Sedation and nausea was significantly higher in tramadol group (p<0.001), 46.66% of patients graded their satisfaction score as good and 15% as excellent in piroxicam group.
Intra-muscular piroxicam was effective in reducing post-caesarean section pain for 24 hours with minimal side-effects compared to tramadol.
剖宫产术后疼痛会带来压力且不利。有效且快速地减轻疼痛有助于产妇早期下床活动以及照顾新生儿。非甾体类抗炎药（NSAIDs）和阿片类药物用于缓解疼痛，但它们对母亲和孩子都有不良反应。
评估吡罗昔康和曲马多在剖宫产术后疼痛治疗中的疗效和安全性。
择期剖宫产的初产妇在麻醉恢复后，分别接受肌肉注射20mg吡罗昔康或100mg曲马多。使用视觉模拟评分法（VAS）评估疼痛严重程度，并记录药物的副作用。如果VAS评分超过4分，则给予2mg的解救镇痛药布托啡诺。术后12小时评估患者的满意度评分。
吡罗昔康组和曲马多组的平均年龄分别为23.32±3.43岁和22.03±2.0岁。两组在术后2、4、8、12和24小时疼痛均显著减轻（p<0.001）。与曲马多组相比，吡罗昔康组在术后2、4和8小时疼痛缓解更显著。曲马多组和吡罗昔康组分别有21例和12例患者接受了解救镇痛。曲马多组的镇静和恶心发生率显著更高（p<0.001），吡罗昔康组46.66%的患者将满意度评分评为良好，15%评为优秀。
与曲马多相比，肌肉注射吡罗昔康在24小时内有效减轻剖宫产术后疼痛，且副作用最小。
