Abstract :
Introduction: Postoperative pain control is an important component of surgical patient care. Inadequate
pain control in postoperative period increases mortality and morbidity to great extent. Studies have shown
transdermal diclofenac is as effective as intramuscular diclofenac injection in postoperative analgesia, but
a comparison of diclofenac rectal suppository and transdermal route is lacking. This research proposal
intends to study and compare the effectiveness of Diclofenac transdermal patch and rectal suppository.
Study Design: Randomized, Single Blind, Prospective, Comparative study.
Materials and Methods: ASA 1 and 2 patients scheduled for open cholecystectomy withsample size
60 patients divided between group TD (transdermal patch, n=30) and RS (rectal suppository, n=30). 100
mg diclofenac epolamine patch was applied on inner aspect of left arm in TD group’s 1hr before incision
Patch was changed 12hrly for 48 hrs. 100 mg diclofenac sodium was introduced per-rectally in PR group
just before induction of anesthesia and repeated 12hrly for 48hrs. Each patient was monitored and data
collected in PACU, PCA remote was again shown to patients and advised them to press button whenever
they feel.
Result: It has been found that both the groups were comparable in their demographic distribution, in terms
of age and sex. 14 readings were taken from just after OT till 48hrs from starting surgery. None of the
patients in the study showed the sign or symptoms of opioid overdosing. The pain was better controlled
with Diclofenac through per rectal route than the transdermal route.
Conclusion: Considering mean rank of VAS till 6hrs after skin incision and drugs given during 1st , 2nd
and 3rd readings at 6th hr., 12th hr., 18th hr. and continue 6hrly and total drugs given till 48hrs, pain after
open cholecystectomy was better controlled with diclofenac sodium rectal suppository in comparison to
diclofenac epolamine patch.
Keyword :
Open cholecystectomy, Diclofenac sodium rectal suppository, Diclofenac epolamine, Patch, PCA pump.