Role of Diclofenac Suppositories in Pain Relief During the Postpartum Period

Abstract

Objective: To compare the efficacy of rectal diclofenac suppositories and oral mefenamic acid in relieving pain during the postpartum period.

Methodology: This randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Shifa International Hospital, Islamabad, from October 2024 to March 2025. A total of 170 postpartum women meeting inclusion criteria were randomly allocated to receive either rectal diclofenac (100 mg every 8 hours) or oral mefenamic acid (500 mg every 8 hours). Pain levels were assessed using the Visual Analog Scale (VAS) at baseline and 8 hours post-analgesic administration. Pain scores were compared among the two-group using independent sample t-test. A p-value of < 0.05 was considered statistically significant.

Results: The results demonstrated significantly lower mean pain scores in the rectal diclofenac group (2.5 ± 1.1) compared to the oral mefenamic acid group (4.0 ± 1.5; p = 0.004). Both groups exhibited comparable baseline characteristics, including age, BMI, gestational age, and parity. No significant differences were observed in perineal trauma severity, labor duration, or mode of delivery.

Conclusions: The rectal diclofenac has superior analgesic efficacy over oral mefenamic acid in the relief of postpartum pain. Given its effectiveness, safety, and ease of administration, rectal diclofenac is a promising option for managing postpartum pain, particularly when oral analgesics are less effective or poorly tolerated.