COMBINED DEXAMETHASONE AND DICLOFENAC VS SINGLE DICLOFENAC BASED ANALGESIC REGIMEN IN PATIENTS UNDERGOING MAXILLOFACIAL SURGERY: COMPARISON OF POST OPERATIVE ANALGESIA

Abstract

Background: Pain Management is one of the most important aspects in maxillofacial surgery. This study was conducted to compare post-operative analgesic effect of combination of Dexamethasone and Diclofenac with Diclofenac only, in patients undergoing maxillofacial surgery under GA. Materials and Method: Sixty adult patients of both genders of ASA physical status I and II undergoing maxillofacial surgery were randomly allocated in two groups. In Group C (n=30) patients received combination of injection dexamethasone (8 mg IV) and injection diclofenac sodium (75 mg) in 1st bottle of NS. In Group D (n=30) patients received injection diclofenac sodium (75 mg) in 1st bottle of NS and 2 ml NS IV (placebo). Intensity of post- operative pain was assessed by VAS score at 0,1,4,8,12,24 hours after surgery. Duration of analgesia was noted from time of 1st administration of rescue analgesic and total amount of rescue analgesic needed in 1st 24 hours was also calculated. Results: Both the groups were comparable with respect to mean age, gender, body weight. VAS score of Group C was significantly lower than Group D with p <0.05. Mean duration of analgesia in Group C was significantly higher than Group D with p <0.001. Consumed dose of rescue analgesic (injection paracetamol) was higher in Group D than Group C with p <0.05. Lesser Cumulative VAS scores were observed in Group C at 0,1,4,24 hours with p value < 0.05. Conclusion: Combination of injection diclofenac and dexamethasone is superior analgesic regimen than single diclofenac in maxillofacial surgery with lesser VAS score, prolonged duration of analgesia and lesser dose of rescue analgesic.