Naproxen premedication reduces postoperative tubal ligation pain

This study evaluated the effectiveness of naproxen sodium oral premedication in reducing postoperative pain, analgesic requirements and day surgery length of stay in patients undergoing outpatient laparoscopic tubal ligations. We undertook a randomized, double-blind clinical trial on ASA I and ASA II patients undergoing outpatient laparoscopic tubal ligations. The treatment group received two capsules containing naproxen sodium, 275 mg each, and the control group received two identical capsules containing placebo. Postoperative visual analogue pain scores, analgesic requirements, side-effects and length of day surgery stay were studied. Forty-four patients completed the study with 21 patients in the naproxen group and 23 in the placebo group. There was a statistically significant difference between groups in terms of pain score (naproxen group 0.9 +/- 0.2 vs placebo group 3.5 +/- 0.6); patients requiring postoperative opioids (naproxen group 0% vs placebo group 34.8%); and time spent in the day surgery unit (naproxen group 168 +/- 13 min vs placebo group 188 +/- 15 min). There was no difference in the incidence of nausea and vomiting. Only one person developed a side-effect from the naproxen sodium which was minor gastric discomfort. This study shows that naproxen decreased the postoperative tubal ligation pain with less subsequent postoperative analgesic requirements, less time to street fitness and no increase in analgesic side-effects. We recommend the use of this premedication in outpatient laparoscopic tubal ligations.