Postoperative pain control after cesarean section: Can diclofenac sodium be used instead of meperidine?

Objective. To determine the advantages and disadvantages of the use of diclofenac sodium instead of meperidine for postcesarean section pain control. Methods. A total of 130 patients who had undergone cesarean section at the Department of Obstetrics and Gynecology of Gazi University Hospital were prospectively randomised to receive one of two postoperative pain control regimens. The first group of patients received intramuscular diclofenac sodium at a dose of 2 x 75 mg and additional breakthrough meperidine was given intramuscularly at 50 mg dosages each time, if necessary. Patients in the second group received only 6 x 50 mg meperidine. Results. Twenty-seven of the 65 patients in the diclofenac group complained of unrelieved pain within the subsequent 24 h postoperatively. Patients receiving diclofenac alone or a combination of diclofenac + meperidine were less sedated and the time to the first passing of flatus was shorter than that in the patients treated with only meperidine. Conclusions. Diclofenac alone was safe and effective for the majority of the patients and it decreased the opioid requirements in the remaining patients.