European Journal of Molecular & Clinical Medicine

Background: This study compared the analgesic efficacy of the bilateral erector spinae plane
(ESP) with that of the bilateral transversus abdominis (TAP) postoperative delivery with
selected surgery.
Methods: Sixty mothers scheduled for caesarean section under random surgery were
randomly assigned to receive an ESP block or a TAP block. The ESP group received USG
guided block with 20 mL 0.2% of ropivacaine at the T9 level corresponding to T10 transverse
process e at the end of surgery. The TAP group received an ultrasound-guided TAP block
containing 20 mL of 0.2% ropivacaine at the end of delivery. The main effect was the
duration of analgesia achieved by each block. Measures of the second outcome were
postoperative pain severity, complete diclofenac use, patient satisfaction.
Results: The median duration (interquartile) block was longer in the ESP group than in the
TAP group (12 hours [10-14] vs 8 hours [8-10], p <0.0001). In the first 24 hours, the median
rate of analog pain observed at rest was lower in the ESP group. Intermediate diclofenac use
in the first 24 hours was significantly higher in the TAP group than in the ESP group (125 mg
[100-150] vs 100 mg [75-100, p = 0.003]).
Conclusion: Compared with the TAP block, ESP block provides effective pain relief, has a
long lasting analgesic action, increases duration of first analgesic need, is associated with
minimal diclofenac use, and can be used in multimodal analgesia and opioid -sparing
medication after surgery.

Background: Pain management following caesarean section still remains a challenge in our
environment. Diclofenac suppository is an effective adjunct analgesic for post-operative pain
control. Over the last two decades the number of caesareans being performed has increased
dramatically. High quality postoperative analgesia is important because the new mother has
to recover from major intra-abdominal surgery while also caring for her newborn baby. Many
options are available but tailoring the method to the individual can be problematic because it
has been difficult to predict the severity of postoperative pain or the individual response to a
regimen.

Hemorrhoids are one of the most common anorectal diseases. Hemorrhoidectomy still stands as the most effective treatment for high grade hemorrhoids and postoperative acute pain as an expected result of hemorrhoidectomy has been experienced by thousands of patients all over the world and hence its only obstacle. Pain control using various invasive and noninvasive methods after hemorrhoidectomy has been constantly under debate and investigation. During the study period, 100 consecutive patients undergoing open hemorrhoidectomy under spinal anesthesia are allotted alternatively to each group. So 50 patients in each group of topical 2% diltiazem and diclofenac suppository. The diltiazem group yielded the lowest visual analog scale (VAS) score on post-operative day zero after surgery (p<0.05). The diclofenac group reported the lowest VAS score on following post-operative day one, two after surgery (p<0.05). There were no complications after treatment with either of these drugs. Topical use of diltiazem gel is appropriate for short-term pain control following hemorrhoidectomy, while diclofenac yields a more sustainable pain control.

Background: Postoperative pain may be a significant reason for delayed discharge from
hospital, increased morbidity and reduced patient satisfaction. Nowadays opioids are the
mainstay in the treatment of acute postoperative pain. Pethidine is an opioid.But opioids
produce side effects like nausea, vomiting, sedation, pruritis, respiratory depression.
Diclofenac is a non-selective NSAIDs with good tissue permeability. NSAIDs are particularly
Effectiveincasesofsomaticinflammatorypain.
Objectives: We conducted this study to compare the efficacy of Injection pethidine and
Injection diclofenac as an analgesic for post-operative patients undergoing Hysterectomy.
Methods: This was an open-label prospective study that included 60 female patients
undergoing lower limb orthopedic surgeries aged 20 years and above. Randomly allocated 30
patients were given Pethidine 50 mg IM three times a day and the rest 30 patients were given
Diclofenac 75mg IV two times a day. Post-operative pain scores were recorded using the
Visual Analog Scale (VAS) at 6,12,24and 48 hrs. Statistical analysis was done using unpaired
t-test.
Results: The mean pain score was found less in the diclofenac group compared to the
pethidine group at all intervals by VAS (p<0.05). Nausea and dizziness were more commonly
reportedinthepethidinegroup.
Conclusion: Diclofenac provides effective and better analgesia in acute post-lowerlimb
orthopedic surgery pain than pethidine with fewer adverse effects.