Comparison of rectal tramadol with diclofenac for providing post op analgesia in caesarean sections
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DR.O.SUGANYA MANOHARAN CO AUTHORS PROF.DR.R SELVAKUMAR PROF.DR.B.CHANDRIKA - PowerPoint PPT Presentation


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COMPARISON OF RECTAL TRAMADOL WITH DICLOFENAC FOR PROVIDING POST OP ANALGESIA IN CAESAREAN SECTIONS. DR.O.SUGANYA MANOHARAN CO AUTHORS PROF.DR.R SELVAKUMAR PROF.DR.B.CHANDRIKA PROF.DR.A.CHANDRASEKARAN COIMBATORE MEDICAL COLLEGE,CBE. INTRODUCTION.

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Comparison of rectal tramadol with diclofenac for providing post op analgesia in caesarean sections

COMPARISON OF RECTALTRAMADOL WITH DICLOFENAC FOR PROVIDING POST OP ANALGESIA IN CAESAREAN SECTIONS

DR.O.SUGANYA MANOHARAN

CO AUTHORS

PROF.DR.R SELVAKUMAR

PROF.DR.B.CHANDRIKA

PROF.DR.A.CHANDRASEKARAN

COIMBATORE MEDICAL COLLEGE,CBE.


Introduction
INTRODUCTION

*MODALITIES OF POSTOPERATIVE ANALGESIA ARE MANY.

*RECTAL ROUTE IS ONE AMONG THEM AND IT IS EASIER AND MORE PATIENT COMPATIBLE.

*TRAMADOL IS THE RECENT ENTRY IN SUPPOSITORY FORM.


AIM

  • TO COMPARE TRAMADOL AND DICLOFENAC SUPPOSITORY FOR THEIR ANALGESIC EFFICACY,SIDE EFFECTS AFTER LSCS.


Materials methods
MATERIALS & METHODS

  • DOUBLE BLINDED PROSPECTIVE STUDY

  • 2 GROUPS OF 20 PTS EACH UNDERGOING LSCS UNDER SPINAL ANAESTHESIA ARE SELECTED

  • TO RECEIVE EITHER RECTAL TRAMADOL 100MG OR DICLOFENAC 100MG POST OPERATIVELY.


Observation

DEMOGRAPHIC PROFILE

OBSERVATION


Observation1
OBSERVATION

DURATION OF ANALGESIA WITH VAS LESS THEN 4


Observation2
OBSERVATION

DURATION OF ANALGESIA WITH VAS >4 TILL THE PTS REQUIRE RESCUE ANALGESIA



Discussion
DISCUSSION

  • BRIEF PHARMACOLOGY

  • TRAMADOL –SYNTHETIC 4-PHENYL PIPERIDINE ANALOGUE OF CODEINE,

  • METABOLIZED BY DEMETHYLATION IN LIVER AND EXCRETED THROUGH KIDNEY,

  • IT INHIBITS NA & SERATONIN REUPTAKE AT NERVE TERMINALS THUS ACTIVATING MONOAMINERGIC SPINAL INHIBITION OF PAIN,

  • DICLOFENAC- NSAID.

  • ARYL ACETIC ACID DERIVATIVE.

  • INHIBITS CYCLO OXYGENASE ENZYME.

  • INHIBITS PG SYNTHESIS & HAVE ANTI-PLATELET ACTION.


Review of literature
REVIEW OF LITERATURE

  • EFFECT OF RECTAL DICLOFENAC IN REDUCING POST OP PAIN AND RESCUE ANALGESIA AFTER CARDIAC SURGERIES-DHAWAN,KIRAN,CARDIOTHORACIC CENTRE, AIIMS,NEW DELHI.

  • OPIOD SPARING EFFECT OF RECTAL DICLOFENAC FOLLOWING TOTAL ABDOMINAL HYSTERECTOMY BENEFITS THE PATIENTS BY DR.J.ANAES,2002.


Review of literature1
REVIEW OF LITERATURE

  • EFFECT OF DICLOFENAC SUPPOSITORY ON TRAMADOL CONSUMPTION IN POST HYSTERECTOMY PAIN BY HOSSCU DEPT.OF ANAESTHESIA,AGAKHAN UNIVERSITY,KARACHI.


Summary
SUMMARY

  • 40 PATIENTS UNDERGOING LSCS ARE SELECTED,20 PATIENTS RECEIVE RECTAL TRAMADOL,20 PATIENTS RECEIVE RECTAL DICLOFENAC.

  • TRMADOL SUPPOSITORY HAD A PAIN FREE PERIOD OF 297 MINS(±65.6) COMPARED WITH DICLOFENAC HAVING A PAIN FREE PERIOD OF 170.5 MINS(±58.5).


Summary1
SUMMARY

  • DURATION OF ANALGESIA TILL THE PTS REQUIRING RESCUE ANALGESIA WITH TRAMADOL IS 363MINS(±94) WHILE FOR DICLOFENAC 221.5MINS(±75.4).

  • SIDE EFFECTS EQUAL FOR BOTH GROUPS.


Conclusion
CONCLUSION

  • RECTAL TRAMADOL PROVIDES BETTER AND PROLONGED POST OP PAIN RELIEF COMPARED TO DICLOFENAC IN PTS UNDERGOING LSCS WITH COMPARABLE SIDE EFFECTS.



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