Comparison the Effect of Paracetamol and Ketorolac on Pain Relief after Cesarean Section

Main Article Content

Asadollah Shakeri
Fatemeh Taghizadeh Khorasanian
Maryam Razavi

Abstract

Introduction: Cesarean section is one of the most common surgical procedures in women. Effective pain control is an important component of post-operative care, as calming the mother increases her ability to take care of herself, reduce nosocomial infections, and hospitalization costs. The aim of this study was to compare the effect of paracetamol and ketorolac on the relief of post-cesarean pain in order to find a drug with minimal complications.

Methods: This study was performed on 140 women admitted to Ali Ibn Abi Talib Hospital due to cesarean section. Patients were divided into two groups of 500 mg paracetamol after cord clamp and 30 mg intravenous ketorolac group. Pain score, need for additional analgesia and visual analogue scale (VAS) were measured and compared in two groups. Data were analyzed using SPSS software.

Results: In this study, mean pain scores at 0, 6, 12 and 24 hours were significantly lower in the ketorolac group than in the paracetamol group. There was no complication in any of the experimental groups in this study. There was no significant difference between the mean time of first request for the additional analgesic of two groups. Frequency of additional analgesic request in the ketorolac group was significantly lower than in the paracetamol group.

Conclusion: Overall, the results of this study showed that the rate of pain reduction after cesarean section with ketorolac was significantly higher than paracetamol.

Keywords:
Cesarean section, ketorolac, paracetamol.

Article Details

How to Cite
Shakeri, A., Khorasanian, F. T., & Razavi, M. (2019). Comparison the Effect of Paracetamol and Ketorolac on Pain Relief after Cesarean Section. Journal of Pharmaceutical Research International, 31(6), 1-6. https://doi.org/10.9734/jpri/2019/v31i630351
Section
Original Research Article

References

Bakhsha F, Niaki AS, Jafari SY, Yousefi Z, Aryaie M. The effects of diclofenac suppository and intravenous acetamino-phen and their combination on the severity of postoperative pain in patients undergoing spinal anaesthesia during cesarean section. Journal of Clinical and Diagnostic Research: JCDR. 2016;10(7): UC09.

Merrikhihaghi S, Farshchi A, Farshchi B, Farshchi S, Abedin-Dorkoosh F. Tramadol versus diclofenac in pain management after cesarean section: A cost analysis study. Journal of Pharmacoeconomics and Pharmaceutical Management. 2015;1(1): 22-4.

Miller KE. Use of ketorolac for pain control after cesarean section. American Family Physician. 2004;70(1):191-2.

Ramashwar S. In Asia, cesarean section associated with increased risk of neonatal mortality. International Perspectives on Sexual and Reproductive Health. 2010;36(2):116-118.

Miller RD, Ward TA, Shiboski SC, Cohen NH. A comparison of three methods of hemoglobin monitoring in patients undergoing spine surgery. Anesthesia & Analgesia. 2011;112(4):858-63.

Bamigboye AA, Hofmeyr GJ. Non-closure of peritoneal surfaces at caesarean section-a systematic review. South African Medical Journal. 2005;95(2):123-6.

Zangeneh M, Veisi F, Ebrahimi B, Ghadami MR. Comparing the Effects of Indomethacin-acetaminophen Suppository and Indomethacin Suppository alone on Post Cesarean Section Pain. Journal of Mazandaran University of Medical Sciences. 2014;24(117):157-64.

Lowder JL, Shackelford DP, Holbert D, Beste TM. A randomized, controlled trial to compare ketorolac tromethamine versus placebo after cesarean section to reduce pain and narcotic usage. American Journal of Obstetrics and Gynecology. 2003; 189(6):1559-62.

Wong JON, Tan TDM, Cheu NW, Wang YR, Liao CH, Chuang FH, et al. Comparison of the efficacy of parecoxib versus ketorolac combined with morphine on patient-controlled analgesia for post-cesarean delivery pain management. Acta Anaesthesiologica Taiwanica. 2010;48(4): 174-7.

Amiryamale P, Alijanpour A, Zabihi, A, Atarzade S. H, Shirkhani Z, Rezaei B. Comparison of analgesic effect of intravenous paracetamol and meperidine with meperidine alone on pain after caesarean section elective. Anesthesiology and Pain Journal. 1392;4(1).

Miller KE. Use of ketorolac for pain control after cesarean section. American Family Physician. 2004;70(1):191-2.

Pavy TJ, Paech MJ, Evans SF. The effect of intravenous ketorolac on opioid requirement and pain after cesarean delivery. Anesthesia & Analgesia. 2001;92(4):1010-4.

Jarineshin H, Fekrat F, Kashani S. The effect of paracetamol versus meperidine on postoperative pain of cesarean section. Anesthesia, essays and researches. 2017;11(1):165.

Gin T, Kan A, Lam K, O'Meara M. Analgesia after caesarean section with intramuscular ketorolac or pethidine. Anaesthesia and intensive care. 1993;21(4):420-3.

Darvish H, Memar Ardestani B, Mohammadkhani Shali S, Tajik A. Analgesic efficacy of diclofenac and paracetamol vs. meperidine in cesarean section. Anesth Pain Med. 2013;4(1): e9997.

DOI: 10.5812/aapm.9997.
eCollection 2014

Isiordia-Espinoza MA, Pozos-Guillen A, Martinez-Rider R, Perez-Urizar J. Comparison of the analgesic efficacy of oral ketorolac versus intramuscular tramadol after third molar surgery: A parallel, double-blind, randomized, placebo-controlled clinical trial. Med Oral Patol Oral Cir Bucal. 2016;21(5):e637–e643.
[Published 2016 Sep 1]
DOI: 10.4317/medoral.21077

Lee SY, Lee WH, Lee EH, Han KC, Ko YK. The effects of paracetamol, ketorolac and paracetamol plus morphine on pain control after thyroidectomy. Korean J Pain. 2010;23(2):124–30.

Bakhsha F, Niaki AS, Jafari SY, Yousefi Z, Aryaie M. The effects of diclofenac suppository and intravenous acetamino-phen and their combination on the severity of postoperative pain in patients undergoing spinal anaesthesia during cesarean section. J Clin Diagn Res. 2016;10(7):UC09–UC12.
DOI: 10.7860/JCDR/2016/15093.8120