A Prospective Case-control Study on the Comparison of Postoperative Pain Relief with Transdermal Diclofenac Patch and Injection Diclofenac
Subbhabrata Das
Citation Information :
Das S. A Prospective Case-control Study on the Comparison of Postoperative Pain Relief with Transdermal Diclofenac Patch and Injection Diclofenac. Int J Head Neck Surg 2015; 6 (4):129-133.
This is a randomized case-control study to know the efficacy of postoperative pain relief with transdermal diclofenac patch 200 mg and comparison with injection diclofenac sodium 75 mg.
Materials and methods
A total of 100 patients with head and neck cancer were included in the study and were randomly divided into two groups (A and B). Anesthetic procedure was standardized. A transdermal diclofenac diethylamine patch of 200 mg was applied to group A, just before the skin closure. And in group B, injection diclofenac was given 8 hourly. In group A, injection diclofenac was given on an as-needed basis whenever patient had visual analog scale (VAS) of pain > 5. Visual analog scale at 2nd, 4th, 8th, 12th, and 24th hour postoperatively was recorded for 5 days. Injection diclofenac needed in groups A and B was recorded for five postoperative days and the mean number of injections of diclofenac per patient per day needed in both groups was calculated.
Results
In group A, we needed only 0.96 injections (diclofenac 75 mg)/patient on the first day and no injection was needed further, while in group B, we had to use three injections/day/ patient. Visual analog scale and pain relief were more steady and better in group A as compared with group B.
Conclusion
Transdermal patch of diclofenac diethylamine 200 mg is very effective in providing postoperative analgesia and is better than intravenous injection diclofenac 75 mg.
How to cite this article
Singh SP, Jain DK, Das S, Jain S. A Prospective Case-control Study on the Comparison of Postoperative Pain Relief with Transdermal Diclofenac Patch and Injection Diclofenac. Int J Head Neck Surg 2015;6(4):129-133.
Transdermal controlled systemic medication. New York: Marcel Dekker; 1987. p. 159-176.
Physicochemical aspects of transdermal permeation. J Control Release 1987 Dec;6(1):59-74.
Guidelines for the Use of Non-Steroidal Anti-Inflammatory Drugs in the Perioperative Period. London: The Royal College of Anaesthetists; March 1998.
Oral versus topical NSAIDs in rheumatic diseases—a comparison. Drugs 2000 Sep;60(3):555-574.
NSAID-associated adverse effects and acid control aids to prevent them: a review of current treatment options. Drug Saf 2006;29(2):119-132.
Efficacy and safety of a topical diclofenac solution (Pennsaid) in the treatment of primary osteoarthritis of the knee: a randomized, double-blind, vehicle-controlled clinical trial. Arch Intern Med 2004 Oct 11;164(18):2017-2023.
Polymer matrix consideration for transdermal devices. Drug Dev Ind Pharm 1983;9(4):605-621.
Diclofenac sodium multisource prolonged release tablets—a comparative study on the dissolution profiles. J Pharm Biomed Anal 2005 Apr 1;37(4):679-685.
Topical diclofenac improved pain and physical function with no systemic side effects in primary osteoarthritis of the knee. Evid Based Med 2005;10(3):81.
Buprenorphine TDS: use in daily practice, benefits for patients. Int J Clin Pract Suppl 2003 Feb;(133):19-22.
Topical ketoprofen patch. Drugs R D 2005;6(6): 337-344.
Breaking barriers in transdermal drug delivery. JAMA 2005 May 4;293(17):2083.
Pharmacokinetic profile of a new matrix-type transdermal delivery system: diclofenac diethyl ammonium patch. Drug Dev Ind Pharm 1999 May;25(5):695-700.
Pharmacokinetics and biological availability of diclofenac preparations following intramuscular injection of 75 mg and oral administration of 150 mg of active drug. Z Rheumatol 1988 Jan-Feb;47(1):37-42.
The pharmacokinetics of diclofenac sodium following intravenous and oral administration. Eur J Clin Pharmacol 1979;16(6):405-410.
Last updated on eMC 22-Jun-2014. Available from: http://www.medicines.org.uk/emc/medicine/1343/SPC/Voltarol+SR+and+Retard+Tablets [cited April 18, 2015].
Evaluation of a Diclofenac transdermal patch for the attenuation of venous cannulation pain: a prospective, randomised, double-blind, placebo-controlled study. Anaesthesia 2006 Apr;61(4):360-362.