MORPHINE CONSUMPTION IN PATIENTS RECEIVING RECTAL PARACETAMOL AND DICLOFENAC ALONE AND IN COMBINATION

Paracetamol and diclofenac have different mechanisms of action, and th e combination may be more effective than each drug used alone in treat ing postoperative pain. In a double-blind, controlled design, we studi ed 60 patients undergoing elective abdominal gynaecological surgery, w ho received suppositories of paracetamol 1.5 g, diclofenac 100 mg or a combination of the two before the start of surgery. Patients received morphine in the intraoperative period, and cumulative morphine use fr om a patient-controlled analgesia system was recorded to measure the a nalgesic effect of the suppositories. Morphine consumption was greates t in the group that received paracetamol alone and lowest in the group given the combination (P<0.01). There was no difference in the incide nce of morphine-related side effects between the groups. We conclude t hat a diclofenac-paracetamol combination reduced the amount of morphin e used compared with paracetamol alone.