The Influence of Choice of Pain Control Method on Analgesic effect and Postoperative Progress after Cesarean Section

Lee, Young; Kim, Sa Jin; Kwun, In; Chung, Dae Young; Kim, Chang Yi; Kim, Soo Pyung; Song, Ji Min; Yoo, Jin Hee; Lee, Ji Young; Kim, Jin Chul; Kim, Chang Je

Abstract

OBJECTIVE
We investigated influence of choice of pain control method on analgesic effect and postoperative course after cesarean section.
METHODS
Ninety parturients were randomly allocated to three groups and each group had 30 women. The postoperative pain was controlled with classical intramuscular injection in IM group and PCA (patient-controlled analgesia)device in meperidine (D) and meperidine+diclofenac (DV) group for up to 48 hours after Cesarean section when the parturients awoke and complained pain. The parturients received intramuscular diclofenac 75 mg every 12 hours in DV group. We evaluated usefulness and safety of each pain control method on postoperative opioid requirement, numerical rating score of pain, side effect and first ambulation time for 48 hours after operation. RESULTS: Total opioid requirement was decreased almost 40-50% in DV group. Pain score lowered significantly at 6, 12 and 24 hours in DV group(p<0.05). Nausea,Vomiting and Dizziness were increased in IM group than PCA group(p<0.05). There was no difference in laboratory data including hemoglobin, hematocrit, platelet count and bleeding time in diclofenac used group. Ambulation was started earlier significalty in DV group after Cesarean section(p<0.05).
CONCLUSION
We concluded that diclofenac combined PCA is the most effective and safe method in pain control after cesarean section. But it is necessary to try further evaluation of hemostatic effect of diclofenac.