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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DR.O.SUGANYA MANOHARAN CO AUTHORS PROF.DR.R SELVAKUMAR PROF.DR.B.CHANDRIKA

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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

*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

  • 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.


DEMOGRAPHIC PROFILE

OBSERVATION


OBSERVATION

DURATION OF ANALGESIA WITH VAS LESS THEN 4


OBSERVATION

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


SIDE EFFECTS


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

  • 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 LITERATURE

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


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).


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

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


THANK YOU


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