Comparison of the effect of diclofenac suppository with intravenous meperidine in relieving pain after laparoscopic cholecystectomy in opioid-dependent and independent patients

​Introduction: Cholecystitis is one of the most common diagnoses among patients referred to surgical emergencies with acute or recurrent abdominal pain. The mainstay of treatment for this disease is cholecystectomy, and the gold standard procedure is laparoscopic cholecystectomy. Pain which is the most common complication after laparoscopic cholecystectomy gives priority to the administration of the best pain relief medicine. This study aimed to compare the efficacy of diclofenac suppository with intravenous Meperidine for pain relief in opioid-dependent and independent patients undergoing laparoscopic cholecystectomy. Methods: A total of ۱۲۰ opioid-dependent and independent patients (۶۰ each) participated in this single-blinded study. Each group was randomly divided into two equal subgroups and ۱۰۰ mg diclofenac suppository and ۲۵ mg Meperidine via intravenous injection were administered to the participants in each group. Pain intensity was measured by the Verbal Rating Scale (VRS) pain scale ۲۴ hours after recovery. The data were analyzed in SPSS software (version۱۶.۰). A P-value of less than ۰.۰۵ was considered statistically significant. Results: Based on the results of the study, Meperidine for pain relief after laparoscopic cholecystectomy was reported to be more effective in opioid-dependent patients and diclofenac in opioid-independent patients. Moreover, the use of diclofenac in ۹۰% of opioid-independent patients resulted in favorable responses and ease of pain (Fisher=۶۱.۰۱; P=۰.۰۰۱), and the rate of opioid-dependent patients treated with Meperidine with excellent responses was measured at ۸۳.۳% (Fisher=۵۶.۹۸, P=۰.۰۰۱). Conclusions: Meperidine can be the mainstay of treatment for pain relief after laparoscopic cholecystectomy used in opioid-dependent patients; however, the selected drug for pain relief after laparoscopic cholecystectomy in opioid-independent patients is diclofenac.

Keywords:

Cholecystectomy , Diclofenac , Laparoscopy , Meperidine , Pain management