Pre-emptive Effects of Preoperative Diclofenac Suppository on Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: a Case-Control Study

Aiiub Asheghvatan; Zahra Ahmadi; Farzad Kakaei; Mohammadtaghi Khodayari; Mojtaba Ziaee; Allahverdi Arjmand

doi:10.18502/aptj.v3i1.12486

Aiiub Asheghvatan Department of General & Vascular Surgery, Maragheh University of Medical Sciences, Maragheh, Iran.
Zahra Ahmadi Department of General & Vascular Surgery, Maragheh University of Medical Sciences, Maragheh, Iran.
Farzad Kakaei Department of General & Vascular Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Mohammadtaghi Khodayari Department of Statistics, Maragheh University of Medical Sciences, Maragheh, Iran.
Mojtaba Ziaee Department of Pharmacology, Maragheh University of Medical Sciences, Maragheh, Iran.
Allahverdi Arjmand Department of General & Vascular Surgery, Maragheh University of Medical Sciences, Maragheh, Iran.

DOI: https://doi.org/10.18502/aptj.v3i1.12486

Keywords: Diclofenac, Analgesics, Morphine, Pain Management, Cholecystectomy

Abstract

Introduction: Postoperative pain following laparoscopic cholecystectomy is common in abdominal surgeries. Opioids and non-steroidal anti-inflammatory drugs are used in the management of postoperative pain. The current clinical study was undertaken to evaluate the efficacy of a preemptive diclofenac suppository for the alleviation of post-surgery pain and opioid consumption in laparoscopic cholecystectomy patients.

Methods: A total of eighty patients aged 18 to 65 who underwent laparoscopic cholecystectomy in Sina Hospital of Maragheh University of Medical Sciences were included in this prospective, matched case-control study and were randomly allocated to two groups of 40 each. Subjects received 100 mg diclofenac suppository or placebo within 2 h before surgery. The pain score and analgesic consumption data were recorded up to 24 h postoperatively. An Independent t-test was utilized for the analysis of results.

Results: Visual Analogue Scale (VAS) scores in the diclofenac group were statistically lower at 2, 4, 8, and 12 hours compared to the placebo-controlled group. Opioid consumption was statistically significantly reduced in the treatment group compared to the control group (20.0 ± 3.48 vs 54.7 ± 3.63 ml, respectively. Rescue analgesia usage was significantly higher in the control group. Half of the patients in the diclofenac group did not need any opioid drug. Besides, postoperative side effects and hospital staying duration were decreased in the diclofenac group in comparison to the control group.

Conclusion: Current study demonstrates that preemptive diclofenac 100 mg administration could be taken into consideration to alleviate postoperative pain and is a valuable addition to the standard treatment following cholecystectomy pain management.