International Journal of Obstetric Anesthesia
Volume 17, Issue 1 , Pages 9-14 , January 2008

A double-blind randomised controlled trial of paracetamol, diclofenac or the combination for pain relief after caesarean section

  • B. Munishankar
    • ,
  • P. Fettes
    • ,
  • C. Moore
    • ,
  • G.A. McLeod

      Affiliations

    • Corresponding Author InformationCorrespondence to: G A McLeod, University Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK. Tel.: +44 1382 632427; fax: +44 1382 644914.

,Accepted 19 June 2007.

References 

  1. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg. 2002;183:630–641
  2. Luthman J, Kay NH, White JB. The morphine sparing effect of diclofenac sodium following caesarean section under spinal anaesthesia. Int J Obstet Anesth. 1994;3:82–86
  3. Montgomery JE, Sutherland CJ, Kestin IG, Sneyd JR. Morphine consumption in patients receiving rectal paracetamol and diclofenac alone and in combination. Br J Anaesth. 1996;77:445–447
  4. Lim NL, Lo WK, Chong JL, Pan AX. Single dose diclofenac suppository reduces post-Cesarean PCEA requirements. Can J Anaesth. 2001;48:383–386
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  6. Dahl V, Hagen IE, Sveen AM, Norseng H, Koss KS, Steen T. High-dose diclofenac for postoperative analgesia after elective caesarean section in regional anaesthesia. Int J Obstet Anesth. 2002;11:91–94
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  9. Siddik SM, Aouad MT, Jalbout MI, Rizk LB, Kamar GH, Baraka AS. Diclofenac and/or propacetamol for postoperative pain management after cesarean delivery in patients receiving patient controlled analgesia morphine. Reg Anesth Pain Med. 2001;26:310–315
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  11. Chandrasekharan NV, Dai H, Roos KL, Evanson NK, Tomsik J, Elton TS, et al. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure, and expression. Proc Natl Acad Sci USA. 2002;99:13926–13931
  12. Hyllested M, Jones S, Pedersen JL, Kehlet H. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth. 2002;88:199–214
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  14. Stocker ME, Montgomery JE. Serum paracetamol concentrations in adult volunteers following rectal administration. Br J Anaesth. 2001;87:638–640
  15. Aubrun F, Kalfon F, Mottet P, et al. Adjunctive analgesia with intravenous propacetamol does not reduce morphine-related adverse effects. Br J Anaesth. 2003;90:314–319
  16. Remy C, Marret E, Bonnet F. Effects of acetaminophen on morphine side-effects and consumption after major surgery: meta-analysis of randomized controlled trials. Br J Anaesth. 2005;94:505–513
  17. Botting R. COX-1 and COX-3 inhibitors. Thromb Res. 2003;110:269–272
  18. Munsterhjelm E, Niemi TT, Syrjala MT, Ylikorkala O, Rosenberg PH. Propacetamol augments inhibition of platelet function by diclofenac in volunteers. Br J Anaesth. 2003;91:357–362
  19. Fletcher D, Benoist JM, Gautron M, Guilbaud G. Isobolographic analysis of interactions between intravenous morphine, propacetamol, and diclofenac in carrageenin-injected rats. Anesthesiology. 1997;87:317–326

PII: S0959-289X(07)00126-4

doi: 10.1016/j.ijoa.2007.06.006

International Journal of Obstetric Anesthesia
Volume 17, Issue 1 , Pages 9-14 , January 2008

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