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Transcription

1 independent t-test Repeated Measuer SSS.

2 NSAID) NSAIDs COX-2 COX-1 - Non- Steroidal Anti Inflammatory Drug

3 ZUMS.REC VAS American society II ASA I IRCT N1 of anesthesiologist ad Score Hb VAS Scale Visual Analogu VAS II I ASA NSAID B. Braun Melsungen, Germany L4-L5 L3-L4 AstraZeneca

4 HTN. Measuer Repeated independent t-test SSS

5 p-value Mean SD Mean SD p-value Repeathed Measure F

6 p-value Repeathed Measure F

7 -value Mean SD Mean SD

8 References 1- Labib NY, Mortada MM, Guirguis WW, Abd El-Aziz HM. Cesarean section deliveries in one health insurance hospital in Alexandria. J Egypt ublic Health Assoc. 2007; 82: Tampakoudis, Assimakopoulos E, Grimbizis G, et al. Cesarean section rates and indications in Greece: data from a 24-year period in a teaching hospital. Clin Exp Obstet Gynecol. 2004; 31: akar Tadbiri SH, Rahimi E. Comparison of morphine and piroxicam in decreasing post cesarean pain. Scientif J Kurdistan Uni Med Sci. 2001; 19:

9 4- Neysani E, Ajori L, Arabi F, Azargashb E, Nakhoda K. Comparing analgetic effect of indomethacin suppository and intramuscular pethidine in post cesarean section period. J Shahid Beheshti Unive Med Sci. 2008; 32: Liu SS, Wu CL. The effect of analgestic technique on postoperative patient-reported out comes including analgesia: a systemic review. Anesth Analg. 2007; 105: Akhavanakbari G, Entezariasl M, Isazadehfar K, Kahnamoyiagdam F. The effects of indomethacin, diclofenac, and acetaminophen suppository on pain opoids consumption after cesarean section. erspect Clin Res. 2013; 4: Zahiri Soroori Z, Sharami H, Heidarzadeh A, Shokri L. The comparison between suppository diclofenc and pethidine in post-cesarean section pain relief: a randomized controlled clinical trial. J Gilan Univ Med Sci. 2006; 11: Surakarn J, Tannirandorn Y. Intramuscular diclofenac for analgesia after cesarean delivery: a randomized controlled trial. J Med Assoc Thai. 2009; 92: Lavand homme. Improving postoperative pain management: Continuous wound infusion and postoperative pain. Eur J ain Suppl. 2011; 5: Standing JF, Tibboel D, Korpela R, Olkkola KT. Diclofenac pharmacokinetic meta-analysis and dose recommendations for surgical pain in children aged 1 12 years. ediatric Anaesthesia. 2011; 21: Gan TJ. Diclofenac: an update on its mechanism of action and safety profile. Curr Med Res Opin. 2010; 26: Murphy F. NSAIDs and postoperative pain. BMJ. 1993; 306: Wang S, Saha R, Shah N, et al. Effect of intravenous acetaminophen on postoperative opioid use in bariatric surgery patients. T. 2015; 40: Inal MT. Treatment of fever and pain with paracetamol infusion after caesarean section. Int J ain. 2007; 6: Biri A, Bozkurt N, Korucuoglu U, Yilmaz E, Tiras B, Guner H. Use of pictorial chart for managing menorrhagia among Turkish women. J Turkish-German Gynecol Assoc. 2008; 9: Rahimzadeh, Imani F, Alimian M, Behzadi B, Faiz H. Comparsion between ketamine and acetaminophen administered at the end of anesthesia for pain management after hysterecrtomy. JA. 2013; 4: Turan M, Celık NS, Tuncay FS. I.V. paracetamol infusion is better than I.V. meperidine infusion for postoperative analgesia after caesarean section. The Internet Journal of Anesthesiology. 2006; Moslemi Tabrizi F, Rasooli S. Comparison of postoperative pain control with combined rectal diclofenac and oral paracetamol versus rectal diclofenac in cesarean delivery under spinal anesthesia. J Tabriz Univ Med Sci. 2012; 35:

10 19- Siddik SM, Aouad MT, Jalbout MI, Rizk LB, Kamar GH, Baraka AS. Diclofenac and/or propacetamol for postoperative pain management after cesarean delivery in patients receiving patient controlled analgesia morphine. Reg Anesth ain Med. 2001; 26:

11 Comparison of the Effect of Diclofenac Suppository and Intravenous aracetamol on ost Cesarean ain and Bleeding Molaei B 1, Fallah R 2, kazemi A 1, Rashtchi V 3, Soltani S 4 1 Dept.of Obstetrics and Gynecology, Faculty of Medicine,Zanjan University of Medical Sciences, Zanjan, Iran 2 Dept.of Biostatistics, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran 3 Dept.of Anesthesiology, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran 4 Zanjan University of Medical Sciences, Zanjan, Iran Corresoinding Author: Rashtchi V, Dept.of Anesthesiology, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran vrashtchi@gmail.com Received: 13 Mar 2017 Accepted: 10 Dec 2017 Background and Objective: The cesarean section is one of the most common surgical procedures performed today. Two common complications are pain and bleeding which, if incorrectly controlled, may develop into increased complications. The aim of this research was to compare the effects of diclofenac suppository and intravenous paracetamol on post-cesarean pain and bleeding. Methods and Materials: In this clinical trial, 88 patients (ASA class I and II, years old) who underwent elective cesarean under spinal anesthesia were randomly divided into two groups.in the first group,100 mg diclofenac suppository was administered and in the second group 1g IV paracetamol in 100 ML normal saline was administered immediately after transfer to recovery section and repeated every 6 hours for 24 hours. ain assessment was done by Visual Analogue Scale (VAS) before intervention and after 6, 12, 18 and 24 hours. The control of postpartum hemorrhage was assessed by clinical examination, measurement of Hemoglobin 6 and 12 hours after surgery and ad Score. Data were analyzed by repeated measures and independent t-test via SSS 16. Results: The mean score of pain and severe bleeding in the paracetamol group was significantly lower than in the diclofenac group (p<0.05). Conclusion:According to the results of this study, intravenous paracetamol is more effective than diclofenac suppository in controlling post-cesarean pain and bleeding. Keywords: ain, Bleeding, Cesarean, aracetamol, Diclofenac