Bupivacaine Plus Diclofenac Versus Bupivacaine Alone for Postoperative Pain Relief in Gynecologic Cancer Patients

Comparison of Bupivacaine Peritoneal Infiltration and Intramuscular Diclofenac Versus Bupivacaine Peritoneal Infiltration Alone for Postoperative Pain Relief in Gynecologic Cancer Patients Undergoing Open Surgery

compare the postoperative pain between Bupivacaine peritoneal Infiltration plus immediately postoperative intramuscular Diclofenac and Bupivacaine peritoneal infiltration alone by using visual analogue score (VAS).

The primary objective is to compare the postoperative pain between Bupivacaine peritoneal Infiltration plus immediately postoperative intramuscular Diclofenac and Bupivacaine peritoneal infiltration alone by using visual analogue score (VAS). The secondary objective is to evaluate the time to first dose and the total amount of morphine requirement after the operation in both groups.

Inclusion Criteria:

• gynecologic cancer patients ,i.e. cervical cancer, endometrial cancer, or ovarian tumor suspicious for malignancy
• who has scheduled for operation via laparotomy route
• Women who has ASA physical status I-II
• All of the have age more than 20 years old
• able to communicate in Thai
• Women who agrees to participate in this study

Exclusion Criteria:

• patient who had emergency conditions - indication for emergency operation

• intraoperative cardiac arrhythmia

• operation purpose for only tumor biopsy

  • Women who have abnormal kidney function test (Cr > 1.5)
  • Women with history of gastrointestinal bleeding
  • Women who take the antiplatelet or anticoagulant medications
  • Women with history of allergy to bupivacaine and NSAIDs
  • Women who cannot evaluated pain score