Document Detail


Does the opioid-sparing effect of rectal diclofenac following total abdominal hysterectomy benefit the patient?
MedLine Citation:
PMID:  12067012     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this prospective, double-blind, randomized, placebo-controlled clinical trial was to investigate the opioid-sparing effects of rectal diclofenac following total abdominal hysterectomy. METHODS: Forty ASA I-II patients, aged 20-60 yr, were randomized to receive identical-looking suppositories of either diclofenac 75 mg or placebo, twice daily. All patients were given a standardized anaesthetic, with intravenous morphine via a patient-controlled analgesia device and either diclofenac or placebo for postoperative analgesia. RESULTS: The median 24 h morphine consumption (interquartile range) was significantly higher (P=0.02) in the placebo group [59 (45-85) mg] than in the diclofenac group [31 (14-65) mg]. In comparison with the placebo group, there were significant reductions in total pain score in the diclofenac group at rest (P=0.04) and on movement (P<0.01). Total (SD) sedation score was significantly lower (P=0.04) in the diclofenac group [90 (73) mm] than in the placebo group [148 (89) mm]. Total (interquartile range) nausea score was significantly lower (P<0.01) in the diclofenac group [14 (0-53) mm] than in the placebo group [64 (30-109) mm]. There was no significant difference between the two groups of patients in episodes of vomiting or number of rescue antiemetics. CONCLUSIONS: Rectal diclofenac reduces morphine consumption, improves postoperative analgesia, and reduces the incidence of adverse effects such as sedation and nausea.
Authors:
A Ng; J Parker; L Toogood; B R Cotton; G Smith
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  88     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-06-17     Completed Date:  2002-07-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  714-6     Citation Subset:  IM    
Affiliation:
University Department of Anaesthesia, Critical Care and Pain Management, Leicester Royal Infirmary, UK.
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MeSH Terms
Descriptor/Qualifier:
Administration, Rectal
Adult
Analgesics, Opioid / administration & dosage*,  therapeutic use
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Diclofenac / therapeutic use*
Double-Blind Method
Drug Administration Schedule
Drug Therapy, Combination
Female
Humans
Hysterectomy*
Middle Aged
Morphine / administration & dosage,  therapeutic use
Pain, Postoperative / prevention & control*
Prospective Studies
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anti-Inflammatory Agents, Non-Steroidal; 15307-86-5/Diclofenac; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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