Rectal Versus Oral Analgesia for Perineal Pain Relief After Childbirth

Abstract

Background: To compare the efficacy of rectally administered diclofenac sodium with orally administered mefenamic acid for relief of perineal pain associated with childbirth. Methods: In this randomized control trial, 324 women were randomly allocated in two groups(Group A and B) of 162 each. Groups A patients received diclofenac rectal suppositories and group B patients received oral mefenamic acid. Treatment packs contained either two 50mg diclofenac suppositories or mefenamic acid tablets 500mg. First suppository being inserted when suturing was complete, and second was offered 12-24 hours after birth. Women in group B were given oral mefenamic acid tablets 08 hourly. Women were asked to complete questionnaire at 24 and 48 hours, after birth, relating to their pain relief using validated short form of McGill pain questionnaire Results: There was statistically significant difference between the two groups for sensory, affective and total pain scores at rest or with movement at 24 hours after childbirth. Pain scores were significantly lower in diclofenac group (p value ≤ .0001) when compared to mefenamic acid group. The difference was not sustained 48hours after birth. Conclusion: The use of rectal non-steroidal anti-inflammatory drug suppositories is simple, effective and safe method of reducing the pain experienced by women following perineal trauma within 24 hours after childbirth.