A COMPARISON OF THE EFFECT OF INTRAMUSCULAR DICOFENAC, KETOROLAC OR PIROXICAM ON POSTOPERATIVE PAIN FOLLOWING LAPAROSCOPY

Sixty patients presenting for in-patient gynaecological laparoscopic s urgery were randomly allocated to receive either diclofenac 75mg (n=20 ), ketorolac 30mg (n=20) or piroxicam 20mg (n=20) as an intra-muscular injection immediately after induction of anaesthesia, Postoperative v isual analogue scores over the first 24 hours, using a 10cm scale, ran ged from 3.2-0.5 in the diclofenac group, 2.7-0.85 in the ketorolac gr oup and 2.8-0.5 in the piroxicam group, The scores did not differ sign ificantly between the three groups (p>0.05), Mean time (SD) to first a nalgesia was 27(94) minutes in the piroxicam group, 16 (30) minutes in the diclofenac group and 62 (120) minutes in the piroxicam group, Six out of twenty patients in the diclofenac group required further analg esia compared to nine out of twenty in the other two drug groups, This difference was not significant, There were no reports of increased bl eeding, bronchoconstriction, bleeding from the upper gastrointestinal tract, renal impairment or pain from the intra-muscular injection site in any of the groups. The administration of a non-steroidal anti-infl ammatory drug to patients presenting for laparoscopic surgery reduces postoperative pain, There were no obvious differences between the agen ts used.