Study of Intravenous Diclofenac Sodium as Preemptive Analgesia in Laparoscopic Surgeries

Objective: Pain associated with tissue damage results in prolonged modulation of the somatosensory system, with increased responsiveness of both peripheral and central pain pathways. The aim of this study was to investigate preemptive analgesic effects of intravenously administrated diclofenac sodium in patients undergoing laparoscopic surgeries.

Place & Duration of Study: Study was conducted in MVJ MC & RH from 2009 to 2011.

Method: This study was carried out on 100 patients, divided into 2 groups randomly. Group I 50 patients received plain normal saline and group II 50 patients received 75mg of diclofenac sodium in normal saline intravenously before induction. Anesthetic procedure and drugs were same to all the patients. Visual analogue scale was explained to patients during pre-anesthetic evaluation. Post operatively pain was assessed by visual analogue scale and results were recorded and compared between two groups.

Results: Most of the patients in group I experienced moderate pain (n 32) and severe pain (n 10) and required analgesic drugs by 6 hour. In group II diclofenac was used for preemptive analgesia. Post operatively at 6th hour in group II most (n 29)of the patients experienced no pain to mild pain, and postoperative analgesic requirement was also less.

Conclusions: Inhibition of prostaglandin production by the NSAIDs both peripherally and centrally should, therefore, decrease postoperative discomfort and reduce opioid requirement. Preemptive analgesia in laparoscopic surgeries with diclofenac sodium was effective in blocking noxious stimuli and central sensitization, with subsequent prevention of acute post-operative pain as well as reduced the need for supplemental analgesia. Compared to opioids, NSAIDS (diclofenac) are associated with fewer side effects, so most appropriate for daycare surgeries.