Diclofenac 75mg/1ml intradeltoid inj for postoperative pain

BACKGROUND: Diclofenac 75mg/3ml intragluteal injection is currently used for postoperative pain management. Studies have shown that standard needles do not reach gluteal muscles of patients with Body Mass Index (BMI) ≥ 25 kg/m2. Also, larger volume for injection causes more muscle damage as compared to lesser volumes. Objective of this study was to compare safety and efficacy of diclofenac 75mg/1ml intradeltoid injection versus diclofenac 75mg/3ml intragluteal injection for postoperative pain management in patients with BMI ≥ 25 kg/m 2 . MATERIALS AND METHODS: In this active controlled, multicentric study, enrolled subjects (n=189) were randomized to receive either Diclofenac 75mg/1ml intradeltoid injection or Diclofenac 75mg/3ml intragluteal injection. Study drugs were administered at 0 (baseline), 12, 24 and 36 hours. Time to onset of analgesia, postoperative pain intensity, degree of pain relief, pain at site of injection, local reactions or any other adverse events were recorded upto 12 hr after each dose over 48 hour study period. Global assessment of treatment was also recorded at end of study. RESULTS AND DISCUSSION: Both the study drugs were comparable in terms of degree of pain relief. Significantly faster onset of analgesia (p<0.0001); lesser intensity of pain at site of injection [ (p<0.0046 at 1 hr and (p<0.0001) at 12 hr] and lesser incidence of local reactions at the site of injection were observed with diclofenac 75mg/1ml intradeltoid injection. Global assessment of treatment was favorable for diclofenac 75mg/1ml intradeltoid injection. CONCLUSION: Diclofenac 75mg/1ml intradeltoid injection can be a better alternative for post operative pain management in patients with BMI ≥ 25 Kg/m 2 .