Shruti Brahmbhatt, Devashree Shah, Heena Rajput, Hitanshi B Patel
Both diclofenac sodium and tramadol are effective in reducing postoperative pain following a cesarean section. Diclofenac provides a faster onset of analgesia, while tramadol offers sustained pain relief. Adverse drug reaction incidence was similar in both groups, although gastrointestinal symptoms were more common with diclofenac. Analgesic choice should be individualized based on patient factors, contraindications, and clinical context.
INTRODUCTION: Effective postoperative pain control is an essential component of patient care. Cesarean section is one of the most common surgical procedures, and adequate post-cesarean pain management is necessary to facilitate enhanced recovery, improve neonatal outcomes by promoting breastfeeding and mother-infant bonding, and reduce pain-related adverse effects. Although opioids have been the mainstay of postoperative analgesia, their adverse effects limit their use. Non-steroidal anti-inflammatory drugs have gained popularity as alternatives.
METHODS: This prospective observational comparative study was conducted at a tertiary care hospital in Gujarat among female patients aged >18 years who had undergone cesarean delivery and were prescribed either tramadol or diclofenac sodium for postoperative pain management by the treating clinician. Pain was assessed using the Visual Analog Scale (VAS) at baseline and at 30 minutes, two, six, 12, and 24 hours. Adverse drug reactions were recorded. Statistical analysis was performed using standard parametric tests, with p < 0.05 considered significant.
RESULTS: A total of 50 participants completed the study (tramadol group: n = 25; diclofenac group: n = 25), with comparable baseline characteristics. Both groups showed significant improvement in VAS scores over time (intra-group p < 0.001). Inter-group comparison demonstrated a statistically significant difference at 30 minutes, two hours, and six hours (p < 0.05), but not at 12 and 24 hours (p > 0.05). The mean reduction in VAS score at two hours was 2.4 in the tramadol group and 2.92 in the diclofenac group. The incidence of adverse drug reactions was comparable between groups (p > 0.05).
CONCLUSION: Both diclofenac sodium and tramadol are effective in reducing postoperative pain following a cesarean section. Diclofenac provides a faster onset of analgesia, while tramadol offers sustained pain relief. Adverse drug reaction incidence was similar in both groups, although gastrointestinal symptoms were more common with diclofenac. Analgesic choice should be individualized based on patient factors, contraindications, and clinical context.