A Randomized Controlled Trial To Compare The Efficacy Of Transdermal Diclofenac Patch With Intramuscular Diclofenac As Pre-Emptive Analgesia In Patients Undergoing Lichtenstein’s Inguinal Hernioplasty

Abstract

Background and objectives Postoperative pain is a common problem in any surgical setup and requires appropriate analgesia. This study was planned to assess the efficacy of transdermal diclofenac patch, a new modality in the surgical pain management, with intramuscular diclofenac sodium (75 mg) as pre-emptive analgesia in patients undergoing Lichtenstein’s inguinal hernioplasty. Methodology This one year randomized controlled trial was carried out in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2014 to December 2014. A total of 60 patients diagnosed with inguinal hernia and posted for Lichtenstein’s inguinal hernioplasty were studied. Patients were divided into two groups of 30 each as Group A (single transdermal diclofenac patch [100mg]) and Group B (Single intramuscular injection of diclofenac sodium [75mg]). Patients were evaluated for requirement of rescue analgesia in first 24 hours and time at which patient first requires rescue analgesia. Results All the patients in group A and B were males (100%) and mean age was 36.30 ± 7.75 years in group A compared to 35.33 ± 8.40 years in group B (p=0.645). The mean duration of hernia, type and extent of hernia, mean duration of surgery (p>0.050) were comparable in group A and B. Pain as measured by VAS immediately post operative and at three, six, twelve and twenty four hours (p>0.050) was comparable in group A and B. Also, the mean number of doses and time request for first for dose of rescue analgesia did not differ significantly (p>0.050). In group A, erythema was noted in 3.33% of the patients while in group B, 6.67% had pain at injection site and 3.33% had nausea (p=0.612). Conclusion and interpretation Transdermal diclofenac patch is as effective as intramuscular diclofenac sodium in the management of post operative pain among patients undergoing Lichtenstein’s inguinal hernioplasty.