Comparison of Suppository Diclofenac and Oral Acetaminophen Codeine in Pain Relief after Episiotomy

Post partum perineal pain is one of the disturbing problems in women who have recently given birth. It causes limitation in movement, urination, defecation and also restricts taking care of infant and breast feeding. The purpose of this study was to compare the efficacy of two analgesics; suppository Diclofenac sodium and acetaminophen codeine tablet in the management of post episiotomy perineal pain, while sitting, walking and passing urine. In this interventional study which was performed on women who had vaginal delivery and episiotomy in Imam Reza Hospital in Mashhad in year 2008 a total number of 70 women were randomly assigned to receive either suppository Diclofenac (100 mg every 12 hr) or acetaminophen codeine tablet (320 mg every 6 hr) up to 12 hours after episiotomy. The inclusion criteria were vaginal birth with episiotomy. Pain ratings were recorded before the administration of the drugs and 3 hours after last dose by visual-analog scale. Effect of the two drugs on perineal pain relief was compared. Data was analyzed by using of SPSS11.5 and Chi square and Mann-Whitney tests. Suppository Diclofenac sodium is significantly more effective than acetaminophen codeine in pain relief while sitting, walking and urination after episiotomy (p<0.001). Using rectal Diclofenac sodium is a simple, effective method of reducing pain after episiotomy.