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Abstract
Background: Pain after cesarean section may have a negative impact on maternal healing and infant care. Diclofenac sodium commonly used for post caesarean analgesia and can be given by various routes. Administering per rectum can be provide extended pain relief and increased patient comfort compared to intramuscular injection. The present study investigated the effect of per rectal diclofenac and intramuscular diclofenac for providing analgesia following caesarean section.
Objective: To determine the effectiveness of per rectal diclofenac compared with intramuscular diclofenac in reducing post caesarean pain.
Methods: This was a randomized controlled trial was carried out in Department of Obstetrics and Gynaecology Nishtar Hospital Multan from April 2025 to July 2025. One hundred thirty-six patients undergoing elective caesarean section under spinal anaesthetic were randomly divided into two groups: 68 patients in group A were given 75 mg IM diclofenac and 68 patients in group B were given 100 mg PR diclofenac suppository. Visual Analogue Scale (VAS) was used to assess the pain severity at 12 and 24 hours after surgery. The requirement for rescue analgesia and complications was monitored.
Results: Group B (PR group) demonstrated significantly lower mean VAS scores compared to Group A at 12 hours (4.02 ± 1.41 vs. 4.55 ± 1.32, p = 0.024) and at 24 hours (2.74 ± 1.62 vs. 3.82 ± 1.68, p < 0.001). Additionally, the number of patients requiring rescue analgesia was significantly less in Group B than in Group A (41.2% vs 58.8%, p = 0.039). Furthermore, the mean TTFRA was significantly longer in the PR (rectal) group compared to the control group.
Conclusion: Per rectal diclofenac administration is more effective at providing post-caesarean analgesia than intramuscular administration, and results in less rescue analgesia being required and lower pain scores