Analgesic Effects of Intravenous Acetaminophen، Suppository Diclofenac and Intramuscular Tramadol in Pain Control after Cesarean Delivery

Severity of postoperative pain in cesarean is categorized as moderate to severe levels, so it is necessary to use an appropriate analgesic protocol for alleviating post cesarean section pain; it made a better condition for mother for early communication with her baby. The aim of this research was to investigate the effect of intravenous paracetamol (acetaminophen) as an analgesic in comparison with Diclofenac suppository and intramuscular tramadol after cesarean. In this clinical trial study, 105 pregnant women randomly divide in three equal groups after cesarean section. In their post-operative period analgesic protocol for first group was Diclofenac suppository 100mg every 8 hours. For second group intramuscular tramadol 50mg every 8 hours and for third group intravenous acetaminophen 1gr/100ml every 6 hours were prescribed. Pain intensity was assessed at 2, 6, 24 hours after surgery using visual analogue scale. The reparative cesarean was the most indication of cesarean (48.6%). In this three groups visual analogue scale at 2, 6 and 24 hours after surgery had no significant difference (p=0.087). 26 person in Diclofenac group, 22 person in acetaminophen group and 34 person in tramadol group received additional narcotic (p ≤ 0.001). Intravenous acetaminophen or suppository Diclofenac is more effective than intramuscular tramadol for decreasing pain after cesarean section.