A randomized controlled trial examining the effect of naproxen on analgesia during the second day after cesarean delivery

被引:46
作者
Angle, PJ [1 ]
Halpern, SH [1 ]
Leighton, BL [1 ]
Szalai, JP [1 ]
Gnanendran, K [1 ]
Kronberg, JE [1 ]
机构
[1] Sunnybrook & Womens Coll Hlth Sci Ctr, Dept Anesthesiol, Toronto, ON M5S 1B2, Canada
关键词
D O I
10.1097/00000539-200209000-00038
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Whereas nonsteroidal antiinflammatory drugs augment spinal morphine on Day 1, the analgesia gained by simply combining these drugs with conventional "on request" oral regimens on Day 2 is less clear. In this trial, we randomized 80 women undergoing elective cesarean delivery with spinal morphine (0.2 mg) to receive naproxen (500 mg) or placebo every 12 h after surgery. Both groups received conventional therapy with acetaminophen with codeine (on request) and rescue IM opioids. Incision pain on sitting (IPS), incision pain at rest, uterine cramping, and gas pain were evaluated with visual analog scales (0 100). Worst,interval pain (0-10), analgesic use, and side effects were measured over 72 h. At 36 h (primary outcome), naproxen use was associated with reductions in IPS (38.2 +/- 26.0 versus 51.4 +/- 25.7, P = 0.05), incision pain at rest, uterine cramping, and worst interval pain scores. Clinically modest, statistically significant reductions in IPS (P = 0.0001) and opioid use were found over time (P < 0.01). Reductions in the incidence of inadequate analgesia and improvements in overall pain relief (P = 0.0006) on Day I did not persist on Day 2 (overall pain relief, P = 0.057, inadequate analgesia, 24% naproxen versus 27% controls; P = 1.00). The addition of regular doses of naproxen to conventional oral pain therapy after cesarean delivery leads to reductions in IPS at 36 h and pain over Day 2 but does not reduce the incidence of inadequate analgesia.
引用
收藏
页码:741 / 745
页数:5
相关论文
共 13 条
[1]  
ABOULEISH E, 1991, REGION ANESTH, V16, P137
[2]  
[Anonymous], EVIDENCE BASED RESOU
[3]  
Canadian Pharmacists Association, 1999, COMP PHARM SPEC
[4]   Small doses of intrathecal morphine combined with systemic diclofenac for postoperative pain control after cesarean delivery [J].
Cardoso, MMSC ;
Carvalho, JCA ;
Amaro, AR ;
Prado, AA ;
Cappelli, EL .
ANESTHESIA AND ANALGESIA, 1998, 86 (03) :538-541
[5]  
CELLENO D, 1991, REGION ANESTH, V16, P79
[6]   INTRATHECAL AND EPIDURAL MORPHINE-SULFATE FOR POSTCESAREAN ANALGESIA - A CLINICAL COMPARISON [J].
CHADWICK, HS ;
READY, LB .
ANESTHESIOLOGY, 1988, 68 (06) :925-929
[7]  
COHEN SE, 1991, REGION ANESTH, V16, P141
[8]   NONSTEROIDAL ANTIINFLAMMATORY DRUGS - RATIONALE FOR USE IN SEVERE POSTOPERATIVE PAIN [J].
DAHL, JB ;
KEHLET, H .
BRITISH JOURNAL OF ANAESTHESIA, 1991, 66 (06) :703-712
[9]   ANALGESIA AFTER CESAREAN-SECTION - THE USE OF RECTAL DICLOFENAC AS AN ADJUNCT TO SPINAL MORPHINE [J].
DENNIS, AR ;
LEESONPAYNE, CG ;
HOBBS, GJ .
ANAESTHESIA, 1995, 50 (04) :297-299
[10]   PATIENT-CONTROLLED ANALGESIA FOLLOWING CESAREAN-SECTION - A COMPARISON WITH EPIDURAL AND INTRAMUSCULAR NARCOTICS [J].
EISENACH, JC ;
GRICE, SC ;
DEWAN, DM .
ANESTHESIOLOGY, 1988, 68 (03) :444-448