Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of India
Background: Cesarean section (CS) is a common surgical procedure, often accompanied by significant post-operative pain, which can hinder recovery, bonding with the baby, and breastfeeding. Effective pain management is crucial to prevent complications such as chronic pain and depression. Intraperiton...
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Manipal College of Medical Sciences, Pokhara
2024-12-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/70740 |
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| author | Pragyanrani Panda Imran Ahmed Mitesh Kumar Sharma Rajesh De |
| author_facet | Pragyanrani Panda Imran Ahmed Mitesh Kumar Sharma Rajesh De |
| author_sort | Pragyanrani Panda |
| collection | DOAJ |
| description | Background: Cesarean section (CS) is a common surgical procedure, often accompanied by significant post-operative pain, which can hinder recovery, bonding with the baby, and breastfeeding. Effective pain management is crucial to prevent complications such as chronic pain and depression. Intraperitoneal (IP) instillation of local anesthetics, such as Bupivacaine has shown promise in providing analgesia, while intravenous (IV) Diclofenac is a common alternative.
Aims and Objectives: This study aimed to compare the post-operative analgesic efficacy of IP Bupivacaine with IV Diclofenac in parturients undergoing lower segment CS (LSCS).
Materials and Methods: A randomized, double-blind, prospective study was conducted in Deen Dayal Upadhyay Hospital, New Delhi, with 60 patients divided into two groups: Group B received IP Bupivacaine (30 mL, 0.25%) and Group D received IV Diclofenac (1 mg/kg). Post-operative pain was assessed using the Visual Analog Scale (VAS) at various time points up to 24 h. The time to first rescue analgesia and total analgesic requirement were also measured.
Results: Group B had significantly lower VAS scores at 6, 8, 10, 12, and 24 h post-operatively (P<0.05). Time to first rescue analgesia was longer in Group B (7.26±1.04 h) compared to Group D (5.01±0.49 h) (P=0.001), and the total analgesic requirement was lower in Group B (P=0.01). Early breastfeeding was more feasible in Group B.
Conclusion: IP Bupivacaine provided superior analgesia compared to IV Diclofenac, promoting earlier mobilization, bonding, and breastfeeding. It is a simpler and more effective method for post-operative pain management in LSCS. |
| format | Article |
| id | doaj-art-a225cadd7ed345baa88f6534be714bf4 |
| institution | OA Journals |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-a225cadd7ed345baa88f6534be714bf42025-08-20T02:30:48ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762024-12-0115122127https://doi.org/10.3126/ajms.v15i12.70740Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of IndiaPragyanrani Panda 0https://orcid.org/0009-0001-5837-1838Imran Ahmed 1https://orcid.org/0009-0004-3452-5267Mitesh Kumar Sharma2https://orcid.org/0009-0008-3181-701XRajesh De 3https://orcid.org/0000-0002-2957-6711Senior Resident, Department of Anaesthesiology, AIIMS, Bhubaneswar, Odisha, India Assistant Professor, Department of Anaesthesiology, Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, West Bengal, India Assistant Professor, Department of Anaesthesiology, Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, West Bengal, India Assistant Professor, Department of Community Medicine, Malda Medical College and Hospital, Malda, West Bengal, India Background: Cesarean section (CS) is a common surgical procedure, often accompanied by significant post-operative pain, which can hinder recovery, bonding with the baby, and breastfeeding. Effective pain management is crucial to prevent complications such as chronic pain and depression. Intraperitoneal (IP) instillation of local anesthetics, such as Bupivacaine has shown promise in providing analgesia, while intravenous (IV) Diclofenac is a common alternative. Aims and Objectives: This study aimed to compare the post-operative analgesic efficacy of IP Bupivacaine with IV Diclofenac in parturients undergoing lower segment CS (LSCS). Materials and Methods: A randomized, double-blind, prospective study was conducted in Deen Dayal Upadhyay Hospital, New Delhi, with 60 patients divided into two groups: Group B received IP Bupivacaine (30 mL, 0.25%) and Group D received IV Diclofenac (1 mg/kg). Post-operative pain was assessed using the Visual Analog Scale (VAS) at various time points up to 24 h. The time to first rescue analgesia and total analgesic requirement were also measured. Results: Group B had significantly lower VAS scores at 6, 8, 10, 12, and 24 h post-operatively (P<0.05). Time to first rescue analgesia was longer in Group B (7.26±1.04 h) compared to Group D (5.01±0.49 h) (P=0.001), and the total analgesic requirement was lower in Group B (P=0.01). Early breastfeeding was more feasible in Group B. Conclusion: IP Bupivacaine provided superior analgesia compared to IV Diclofenac, promoting earlier mobilization, bonding, and breastfeeding. It is a simpler and more effective method for post-operative pain management in LSCS.https://www.nepjol.info/index.php/AJMS/article/view/70740cesarean section; post-operative pain; bupivacaine; local analgesia; pain measurement |
| spellingShingle | Pragyanrani Panda Imran Ahmed Mitesh Kumar Sharma Rajesh De Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of India Asian Journal of Medical Sciences cesarean section; post-operative pain; bupivacaine; local analgesia; pain measurement |
| title | Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of India |
| title_full | Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of India |
| title_fullStr | Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of India |
| title_full_unstemmed | Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of India |
| title_short | Intraperitoneal Bupivacaine 0.25% versus intravenous Diclofenac on post-operative analgesia in the cesarean section under spinal anesthesia: A prospective randomized comparative study in a tertiary care hospital of India |
| title_sort | intraperitoneal bupivacaine 0 25 versus intravenous diclofenac on post operative analgesia in the cesarean section under spinal anesthesia a prospective randomized comparative study in a tertiary care hospital of india |
| topic | cesarean section; post-operative pain; bupivacaine; local analgesia; pain measurement |
| url | https://www.nepjol.info/index.php/AJMS/article/view/70740 |
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