Publication:

Intramuscular pentazocine versus rectal diclofenac for pain relief after caesarean section: a randomized controlled trial

Background Caesarean section (CS) commonly causes moderate to severe pain in the first 48 hours after surgery with associated discomfort, delayed ambulation, difficulty initiating breastfeeding and prolonged hospital stay. Adequate analgesia after caesarean section is very important for the patient’s comfort, overall wellbeing and recovery. This study compared the analgesic effectiveness of intramuscular Pentazocine with rectal diclofenac following caesarean section and also the side effects of these drugs in Federal Medical Centre, Keffi, North Central Nigeria.

Methods It was an open label single blinded randomized controlled trial carried out among 240 eligible patients scheduled for either elective or emergency caesarean section. Participants were randomised in the ratio 1:1 to use either rectal diclofenac or intramuscular pentazocine. The effectiveness of the drugs on post caesarean section pain relief and maternal satisfaction were assessed using Visual Analog scale (VAS) and Likert's scale respectively. The side effects of the drugs were also assessed.

Results Majority of the participants had mild to moderate pain throughout the 24 hours period of the study with most having moderate pain. There was no statistically significance difference in the effectiveness of the drugs among the two groups (p=0.745), however maternal satisfaction was higher with the rectal diclofenac group compared with the intramuscular pentazocine group (p=0.017).

Conclusions This study showed that suppository diclofenac and intramuscular pentazocine are comparable in pain relief post caesarean section but there was better maternal satisfaction with suppository diclofenac use compared to intramuscular pentazocine use.