Preemptive Intramuscular Diclofenac for Pain Relief after Total Abdominal Hysterectomy

Objectives: To evaluate the effectiveness of preoperative intramuscular diclofenac for pain relief after total abdominal hysterectomy. Methods: A prospective double-blind, randomized study was conducted in 37 patients who underwent total abdominal hysterectomy at our institution between September 2012 and January 2013. The patients were randomly allocated into two groups to receive either single intramuscular 75 mg diclofenac (treatment group; n = 18) or normal saline (control group; n = 19) 20 min before surgery. Total consumption of meperidine over a 24-h period were recorded. The degrees of postoperative pain were assessed at 4, 8, 12, and 24 h postoperatively by using a numeric rating scale and the adverse events relevant to diclofenac were observe. Results: The mean 24-h postoperative meperidine consumption in the treatment group was insignificantly lower compared to that in the control group (46.11+24.77 mg and 68.42+44.63 mg, respectively, p=0.069). Mean pain scores at 4, 8, 12, and 24 h postoperatively in the treatment group were lower than those in the control group (2.83 vs 4.53, p=0.052; 2.83 vs 4.89, p=0.031; 2.78 vs 4.68, p=0.044; 1.28 vs 1.89, p=0.296, respectively). No serious adverse events were observed in both groups. Conclusion: Preoperative intramuscular diclofenac significantly reduced pain scores at 8 and 12 h (while insignificantly decreased 24-h meperidine consumption) after total abdominal hysterectomy.