Abstract:
To evaluate rectal diclofenac sodium in the relief of
perineal pain after trauma during childbirth a
randomized, double blind trial was conducted.
Women with an episiotomy or lesser or equal perineal
tears to second degree including vestibular tears,
which required suturing at the Obstetric Department
(Ward 21), Professorial Unit, Colombo South
Teaching Hospital, Kalubowila were enrolled.
Women were randomly allocated to either diclofenac
sodium or placebo suppositories (Anusol) , using
a random - number table. Treatment packs
contained two, diclofenac sodium 100 mg and
diclofenac sodium 50 mg suppositories or two
placebo suppositories, The first (diclofenac sodium
1 OOmg or placebo) was inserted when suturing was
completed , and the second (50mg diclofenac sod-
-ium or placebo) 12 hours after birth. Women were
asked to indicate their degree of perineal pain
with different activities (resting/ walking/ sitting and
squatting) 24 hours after birth , using visual
analogue scale. Main outcome measure was overall
pain score at 24 hours after birth.
A total of 169 women were recruited, with 84
randomized to diclofenac sodium suppositories
and 85 to placebo. Women in the diclofenac
sodium group were significantly less likely to
experience pain within 24 hours of delivery
(percentage of mean pain score reduction, 45%, P <
.001) with different activities compared placebo.
The use of rectal diclofenac sodium is a simple and
effective method of reducing the pain experienced
by women following perineal trauma within the
first 24hours after childbirth.
This study was done in Colombo South Teaching
Hospital as a partial requirement for MD in
Obstetrics & Gynaecology in March 2008. Results
were included in a thesis with one published paper in
Sri Lanka Journal o f Obstetricians and
Gynaecologists. Abstract presentation was done in
annual scientific session o f Sri Lanka College of
Obstetricians & Gynaecologists.
