Comparison of the effect of oral Diclofenac potassium (Cata-flam) with Diclofenac sodium suppository on postoperative cesarean section pain; a randomized clinical trial

Postoperative pain after cesarean section is one of the import-ant issues in gynecology. Opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are two of the drugs that are used for cesarean pain management. Considering the adverse effects of opioids in the mother and the baby, NSAIDs are preferred in the post-cesarean pain management. This study was designed to compare the effect of oral diclofenac potassium (Cataflam) with diclofenac sodium suppository on postoper-ative cesarean pain.

This randomized clinical trial was conducted on patients who underwent cesarean section in Taleghani Hospital during 2019. Patients were random-ly divided into two groups based on flipping coin. The first group received 100 mg of oral diclofenac potassium every 6 hours and the second group received 100 mg of diclofenac sodium suppository every 6 hours. The pain was assessed 30 minutes, 2 hours, 6 hours, 12 hours, 18 hours and 24 hours after the intervention using visual an-alogue scale (VAS) before and after analgesics.

Eighty-four patients were included in the final analysis. The mean of VAS during the intervention in the diclofenac sodium suppository group and in the Cata-flam group was 3.42 ± 2.1 and 1.93 ± 2.4 respectively (P value = 0.011). Twenty-eight among 46 patients who received opioids due to severe pain (66.7%) were in the di-clofenac suppository group and 18 of them (42.9%) were in the Cataflam group (P value = 0.021).

Diclofenac potassium tablets and diclofenac sodium suppository can re-duce the post cesarean pain. The efficacy of diclofenac potassium tablets (Cataflam) is significantly higher than the diclofenac suppository; however, the complication rate was not significantly different.