Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr-Jun;16(2):156-160.
doi: 10.4103/sja.sja_722_21. Epub 2022 Mar 17.

Effect of preemptive intramuscular diclofenac on minimal effective-dose bupivacaine saddle block for minor perianal surgeries

Roshdi R Al-Metwalli  1 , Alaa M Khidr  1 , Summayah M Fallata  1 , Hitham M A Elsayed  2
Affiliations

Effect of preemptive intramuscular diclofenac on minimal effective-dose bupivacaine saddle block for minor perianal surgeries

Roshdi R Al-Metwalli et al. Saudi J Anaesth. 2022 Apr-Jun.

Abstract

Background: Preemptive analgesics are commonly used to increase analgesic efficacy and patient satisfaction. The aim of this study was to evaluate the preemptive analgesic effect of intramuscular diclofenac on minimal effective dose spinal anesthesia for perianal surgeries.

Materials and methods: Fifty patients ASA I&II were divided randomly into two groups, control group (GC N = 25) and Diclofenac group (GD N = 25), both groups received saddle block with 5% hyperbaric bupivacaine 0.5 mL (2.5 mg). Thirty minutes before the saddle block, patients in GD received 75 mg (3 mL) diclofenac intramuscularly, whereas patients in GC received 3 mL saline intramuscularly. The differences in the time for the first analgesic request, postoperative analgesic consumption as well as, visual analog scale, were our primary outcomes.

Results: Fifty patients (25 in each group) undergoing perianal surgery completed the study successfully. The time to the first request of analgesia was significantly longer in GD 511.8 (108.07) min. compared to the GC 179.56 (49.24) min with P = 0.00001, as well as the total consumption of rescue analgesic (tramadol hydrochloride) was significantly less in GD 66 (23.8) mg compared to 104 (28.5) mg in the GC with P = 0.00001.

Conclusion: Preemptive intramuscular diclofenac sodium with minimal dose bupivacaine saddle block significantly minimized the postoperative analgesic consumption and delayed the first analgesia request after perianal surgery.

Keywords: Diclofenac; preemptive analgesia; saddle block.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Visual Analogue Score. GC=Control group and GD=Diclofenac group
See this image and copyright information in PMC

References

    1. Dauri M, Faria S, Gatti A, Celidonio L, Carpenedo R, Sabato AF. Gabapentin and pregabalin for the acute post-operative pain management.A systematic-narrative review of the recent clinical evidences. Curr Drug Targets. 2009;10:716–33. - PubMed
    1. Fassoulaki A, Melemeni A, Tsaroucha A, Paraskeva A. Perioperative pregabalin for acute and chronic pain after abdominal hysterectomy or myomectomy: A randomised controlled trial. Eur J Anaesthesiol. 2012;29:531–6. - PubMed
    1. White PF. The role of non-opioid analgesic techniques in the management of pain after ambulatory surgery. Anesth Analg. 2002;94:577–85. - PubMed
    1. Kokki H. Nonsteroidal anti-inflammatory drugs for post- operative pain: A focus on children. Paediatr Drugs. 2003;5:103–23. - PubMed
    1. Gudaityte J, Marchertiene I, Karbonskiene A, Saladzinskas Z, Tamelis A, Toker I, et al. Low-dose spinal hyperbaric bupivacaine for adult anorectal surgery: A double-blinded, randomized, controlled study. J Clin Anesth. 2009;21:474–81. - PubMed