• Yuthadej Thaweekul, Komsun Suwannarurk, Karicha Maireang, and Yenrudee Poomtavorn.
• Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. yuthadej06@yahoo.com
• J Med Assoc Thai. 2011 Dec 1; 94 Suppl 7: S52-6.

BackgroundSeveral adjuvant analgesic agents proposed to treat the postoperative pain while reducing the doses of opioid and its derivatives. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in several operative procedures. The present study aimed to demonstrate the morphine-sparing effects of single-dose intramuscular diclofenac sodium in explore laparotomy gynecologic surgery.Material And MethodForty-six patients were randomly assigned to receive 75-mg of diclofenac sodium or normal saline with intramuscular morphine during immediate postoperative period. Additional morphine for pain control was given by patient-controlled analgesia. 24-hour morphine consumption, pain score, adverse effects and satisfaction of the patients were recorded.ResultsMedian morphine consumption among groups was significant difference between placebo and diclofenac group (32 and 19 mg) (p = 0.041). Greater difference was shown in patients who underwent total abdominal hysterectomy (p = 0.009). Catagorical pain score at 6-hour postoperatively was significant lower in diclofenac group (p = 0.006). No significant difference was found between groups in visual analogue pain score, patients' satisfaction, presence of bleeding or nausea and vomiting.ConclusionThe present study demonstrated that single dose of diclofenac sodium has morphine-sparing effects and can be safely used in explore laparotomy gynecologic surgery without significant adverse effects.

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