Efficacy of diclofenac in a single prophylactic dose in postoperative pain

Prophylactic diclofenac (Voltaren) in postoperative pain was studied in 60 surgical patients who underwent either abdominal (30 patients) or superficial (30 patients) surgery. During anaesthesia, no analgesic or narcotic drugs were given. Immediately after surgery, an intravenous infusion of 100 ml normal saline or saline with 75 mg of diclofenac was administered over 10 minutes under double-blind randomized conditions. The 2-hour study period was started when the patients complained of pain or half an hour after the end of anaesthesia. For pain relief during the study period, 4 mg of oxycodone was repeatedly given on demand. The initial mean pain intensity values were significantly higher after abdominal surgery than after superficial surgery but there were no statistically significant differences between diclofenac and placebo groups. The mean amount of oxycodone required after diclofenac was not significantly lower than after placebo (10.9 +/- 1.9 mg vs. 13.1 +/- 1.4 mg after abdominal surgery and 3.2 +/- 0.8 mg vs. 4.0 +/- 1.2 mg after superficial surgery). The pain relief obtained with oxycodone was similar after diclofenac and placebo. According to the present results, prophylactic use of diclofenac does not significantly reduce the need for narcotic analgesics in the immediate postoperative phase in general surgery.