Comparison of diclofenac sodium with indomethacin suppositories for mediolateral episiotomies

The study was carried out to compare the analgesic effect of diclofenac sodium and indomethacin suppositories for management of right mediolateral episiotomy repair.

A total of 70 patients who gave birth vaginally with right mediolateral episitomy were randomly assigned to receive 100 mg diclofenac sodium suppositories/day (G1, n = 35) or 100 mg indomethacin supposotories/day (G2, n = 35) after episiotomy repair and postpartum for three days. Pain ratings were recorded before, the first hour and 24 hours after medication. The verbal rating scale (VRS) and visual analog scale (VAS) were used for pain recording. The independent T test, Mann-Whitney U and Wilcoxon rank test were used for statistical analysis and Spearman correlation analysis was used for comparison between VRS and VAS.

Diclofenac sodium was a more effective analgesic than indomethacin suppositories for right mediolateral episiotomy pain. For G1 the first hour VRS was 2.6 +/- 0.5 points and VAS 4.9 +/- 0.8 points; for G2 the first hour VRS was 3.4 +/- 0.6 points VAS 6.6 +/- 1.2 points; this difference was statistically significant (p < 0.05, Mann-Whitney U test). For G1 at the 24th hour VRS was 1.2 +/- 0.4 points and VAS 2.4 +/- 0.9 points; for G2 at the 24th hour VRS was 2 +/- 0.7 points and VAS was 3.4 +/- 1.3 points; the difference was statistically significant (p < 0.05, Mann-Whitney U test). The first and 24th hour pain scores (VAS1-VAS24, VRS1-VRS24) were decreased dramatically for both groups (p < 0.05, Wilcoxon rank test). A positive correlation was obtained between the first and 24th hour VRS and VAS by Spearman correlation analysis (r(s) = 0.9, n = 70, p = 0.000).

The two analgesics were effective after episiotomy repair, however diclofenac sodium suppositories may be the preferred choice because they were more effective.