Context: Local anaesthetic injection into the wound is a simple way to relieve pain by direct inhibition of noxious impulses from the site of injury. Another approach to modulate peripheral nociceptive trans-mission is to reduce the local expression of mediators that sensitize nociceptors on afferent fibres by local administration of NSAIDs. Aim: Main aim of the study was to compare post-operative analgesic effects produced by wound infusion of diclofenac sodium and 0.125% bupivacaine mixture with intramuscular diclofenac sodium and 0.125% bupivacaine wound infusion in patients undergoing elective caesarean sections. Settings and Design: Prospective randomized comparative study. Materials and Methods: A prospective comparative study was conducted among 80 pregnant ladies of ASA1/ASA2 status undergoing elective caesarean section under spinal anaesthesia and was randomly allocated to 1 of 2 groups. Group-1: bupivacaine+diclofenac wound infusion (n=40); Group-2: bupivacaine wound infusion+ intramuscular  diclofenac inje-ction (n=40). Postoperative pain was assessed using VNS (verbal numeric scale). Patients with VNS score>4 received Inj. tramadol 50mg IM. VNS score  was  monitored on 1st,2nd,4th,6th,8th,12th,16th,20th and 24th post operative hours. Statistical analysis: Independent sample t test and Pearson’s Chi-square test. Results: p=0.073 for total number of rescue anal-gesics requirement between two groups was statistically not significant but both groups were comparable in line and bar diagram for demographic data and VNS scores. Conclusion:  Bupivacine with diclofenac wound infusion is a novel method of post caesarean analgesia sparring systemic diclofenac and opioid administration.

 

Keywords: Bupivacaine; Diclofenac; Wound Infusion; VNS.