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Randomized Placebo Controlled Open Labelled Comparison of Efficacy of Diclofenac Transdermal Patch in Post Operative Pain


Affiliations
1 Durgabai Deshmukh Hospital, 1-9-27, Osmania University Rd, Vidya Nagar, Adikmet, Hyderabad, Telangana, India
2 Bharath School of Pharmacy, Mangalpally, Ibrahimpatnam, Telangana, India
3 Department of Pharmacy, Bharath School of Pharmacy, Mangalpally, Ibrahimpatnam, Telangana, India
     

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Postoperative incisional pain is a common form of acute pain. Recent studies demonstrate that about 50–70% of patients experience moderate to severe pain after surgery. Reasons for this quandary are distinct mechanisms of incisional nociception compared to other pain conditions or lack of an in depth knowledge about the pathophysiology and neuropharmacology of postoperative pain. Acute postoperative pain is followed by chronic pain in 10–50% of individuals which can be severe in about 2-10% of patients undergoing common operations such as groin hernia repair, breast and thoracic surgery, leg amputation, and coronary artery bypass surgery. Therefore, persistent postsurgical pain represents a major, largely unrecognised clinical problem. Iatrogenic neuropathic pain is probably the most important cause of long-term postsurgical pain. Consequently, surgical techniques that avoid nerve damage should be applied whenever possible. Major surgical operations are still followed by pain, organ dysfunction and prolonged convalescence. It has been assumed that sufficient pain relief will improve the surgical outcome with reduced morbidity, need for hospitalization and convalescence. It has been realized that several other factors in perioperative management are important in the control of postoperative recovery and rehabilitation, and that these factors must be considered and revised in order to achieve the advantageous effects of pain relief on outcome. Among the most commonly used pain-relieving techniques [patient-controlled analgesia (PCA) with opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and epidural analgesic techniques], there is evidence that the epidural local anaesthetic or local anaesthetic–opioid techniques are the most effective on providing dynamic pain relief after major surgical procedures. The goal of postoperative pain management is to relieve the pain while keeping side effects to a minimum. This can be best accomplished with a multimodal approach. Minimally invasive surgery and enhanced recovery protocols have addressed pain management in terms of these goals.

Keywords

Postoperative Incisional Pain, Bypass Surgery, Pain Management, Transdermal Patch, Postoperative Recovery and Rehabilitation.
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  • M Esther, K Peter, J Timothy (2007) Postoperative pain-clinical implications of basic research. Best Practice and Research Clinic Anaesthesiology. 21(1): 3-13

  • K Henrik, SJ Troels, JW Clifford (2006) Persistant post surgical pain: risk factors and prevention. The Lancet. 367(9522): 1618-1625

  • H Kehlet, K Holte (2001) Effect of post operative analgesia on surgical outcome. British Journal of Anaesthesia. 87(1): 62-72

  • G Veerabhadram, C Christina (2013) Post operative pain control. Clin colon rectal surg. 26(3): 191-196

  • Sachan R, Bajpai M (2013) Transdermal drug delivery system. International Journal of Research and Development in Pharmacy and Life Science. (3); 748-765

  • R Sachan, B Meenakshi (2013) Transdermal Drug Delivery System: A Review. International Journal of Research and Development in Pharmacy and Life Sciences. 3(1): 748-765

  • K.D Tripati (2013) Essentials of medical pharmacology- seventh edition, section 3, 204

  • A Sadashiv, NB Goswami, S Dipakkumar (2011) Stable transdermal pharmaceutical drug delivery system comprising diclofenac. Zydus Patent.

  • JL Apfelbaum , MA Ashburn, RT Connis , TJ Gan, et al., (2012) Practice guidelines for acute pain management in the perioperative setting: An updated reported by the American society of Anesthesiologists task force on acute pain management. The Journal of the American Society of Anesthesiologists. 116: 248-273

  • American society of Anaesthesiologists (2014). ASA physical status classification system, American Society of Anaesthesiologists

  • D Gould et al. (2001) Visual Analogue Scale (VAS). Journal of Clinical Nursing. 10:697-706

  • DR Govinda, GV Ravikumar, BR Akshay (2016) Post operative pain relief: A comparison of transdermal diclofenac patch with intramuscular dicofenac injection. Indian Journal of Clinical Anesthesia. 3(1):56-61

  • K Vinod, G Sanjeev, V Renu (2017) Diclofenac patch. International Journal of Contemporary Medicine. Feb, 493-495

  • P Birte, R Stefano (2009) Diclofenac epolamine patch. clinical drug investigation. 29(1): 1-9

  • H Predel, G Gallacchi, B Giannetti, J Heidecker, et al. (2004) Diclofenac patch for topical treatment of acute impact injuries: a randomized, double blind, placebo controlled, multicentre study. British Journal of Sports Medicine. 38(3): 318-23

  • T Pragati, Mehta M. (2015) A Study of efficacy of a single dose of a transdermal diclofenac patch and intramuscular diclofenac patch as pre-emptive postoperative analgesia in patient undergoing abdominal hysterectomy. International Journal of Research in Medicine. 4(4): 96-101

  • SG Bradley, R Micheal, P Jill , D Allison, F Erika. (2000) Topical Diclofenac patch relieves minor sports injury pain. Journal of Pain and Symptom Management. 19(4): 287-294

  • H Lin-Fen, H Chang-Zern, C Shiuan-Horng, C Chen-chiao. (2010) Efficacy and side effects of Diclofenac patch in treatment of patients with myofascial pain syndrome of the upper trapezius. Journal of Pain and Symptom Management. 39(1):116-125

  • F Alessander, L Davide, M Emanuela, N Annamaria (2006) Topical diclofenac patch for postoperative wound pain in laparoscopic gynecologic surgery: A randomized study. Journal of Minimally Invasive Gynaecology. 13(3): 195-200

  • F Lennard , R Umaar, A Molajo, (2008) Diclofenac patches for post operative shoulder pain. International Journal of Shoulder Surgery. 2(2): 47-48

  • A Agarwal, S Dhiraaj, A Kumar, V Singhal, U Singh, (2006) Evaluation of a diclofenac transdermal patch for the attenuation of venous cannulation pain: a prospective randomized, double blind, placebo-controlled study. Journal of the Association of Anaesthetists of Great Britain and Ireland. 61(4): 360-362.

  • H Bhaskar, K Pranav, Rajini, (2010) Comparison of transdermal diclofenac patch with oral diclofenac as an analgesic modality following multiple premolar extractions in orthodontic patients: A cross over efficacy trial. Contemporary Clinical Dentistry. 1(3): 158-163


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  • Randomized Placebo Controlled Open Labelled Comparison of Efficacy of Diclofenac Transdermal Patch in Post Operative Pain

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Authors

Niranjan Salunke
Durgabai Deshmukh Hospital, 1-9-27, Osmania University Rd, Vidya Nagar, Adikmet, Hyderabad, Telangana, India
Maniram Kranthi Kumar
Durgabai Deshmukh Hospital, 1-9-27, Osmania University Rd, Vidya Nagar, Adikmet, Hyderabad, Telangana, India
Yogesh
Bharath School of Pharmacy, Mangalpally, Ibrahimpatnam, Telangana, India
Meher Tabassum
Department of Pharmacy, Bharath School of Pharmacy, Mangalpally, Ibrahimpatnam, Telangana, India
P. Pravallika
Department of Pharmacy, Bharath School of Pharmacy, Mangalpally, Ibrahimpatnam, Telangana, India
M. Sampoorna
Department of Pharmacy, Bharath School of Pharmacy, Mangalpally, Ibrahimpatnam, Telangana, India
Pranay Rao
Department of Pharmacy, Bharath School of Pharmacy, Mangalpally, Ibrahimpatnam, Telangana, India

Abstract


Postoperative incisional pain is a common form of acute pain. Recent studies demonstrate that about 50–70% of patients experience moderate to severe pain after surgery. Reasons for this quandary are distinct mechanisms of incisional nociception compared to other pain conditions or lack of an in depth knowledge about the pathophysiology and neuropharmacology of postoperative pain. Acute postoperative pain is followed by chronic pain in 10–50% of individuals which can be severe in about 2-10% of patients undergoing common operations such as groin hernia repair, breast and thoracic surgery, leg amputation, and coronary artery bypass surgery. Therefore, persistent postsurgical pain represents a major, largely unrecognised clinical problem. Iatrogenic neuropathic pain is probably the most important cause of long-term postsurgical pain. Consequently, surgical techniques that avoid nerve damage should be applied whenever possible. Major surgical operations are still followed by pain, organ dysfunction and prolonged convalescence. It has been assumed that sufficient pain relief will improve the surgical outcome with reduced morbidity, need for hospitalization and convalescence. It has been realized that several other factors in perioperative management are important in the control of postoperative recovery and rehabilitation, and that these factors must be considered and revised in order to achieve the advantageous effects of pain relief on outcome. Among the most commonly used pain-relieving techniques [patient-controlled analgesia (PCA) with opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and epidural analgesic techniques], there is evidence that the epidural local anaesthetic or local anaesthetic–opioid techniques are the most effective on providing dynamic pain relief after major surgical procedures. The goal of postoperative pain management is to relieve the pain while keeping side effects to a minimum. This can be best accomplished with a multimodal approach. Minimally invasive surgery and enhanced recovery protocols have addressed pain management in terms of these goals.

Keywords


Postoperative Incisional Pain, Bypass Surgery, Pain Management, Transdermal Patch, Postoperative Recovery and Rehabilitation.

References