A PROSPECTIVE RANDOMIZED COMPARATIVE EVALUATION OF FLUPIRTINE AND DICLOFENAC SODIUM IN POST INGUINAL HERNIA SURGERY PAIN

Introduction: Effective postoperative pain control is an essential component of care of surgical patients. Nonsteroidal anti-inflammatory drugs are mainstay to treat pain and inflammation. Flupirtine is a novel, non-opiate, non-NSAID, centrally acting analgesic without side effects associated with NSAIDs. Aim and Objectives: Prospective, randomized, double blind comparative study to evaluate and compare analgesic efficacy of flupirtine with diclofenac sodium in inguinal hernia surgery. Methods: The study was conducted in tertiary care teaching hospital on 50 patients aged 15-65 yrs of either sex who underwent inguinal hernia surgery between March 2014 and January 2016. Patients with liver and renal failure, hypersensitivity to flupirtine or diclofenac, pregnant/lactating women, bronchospastic disease, inability to understand pain score, prior history of peptic ulcer were excluded from study. The patients were randomly allocated into two groups consisting of 25 patients each: group-A (tab flupirtine 100mg),group-B (tab diclofenac sodium 50mg). Pain was evaluated in detail using simple and sensitive visual analog scale. Results: The mean age of the participants was 37.57±12.02 yrs in group A and 37.82±13.43 yrs in group B(p>0.05 ) with male-to-female ratio 3:1. The mean weight of the participants was 66.72±12.90 vs 64±13.10 kg (p>0.05). The mean VAS values observed were 1.36±1.77 at baseline, 1.24±2.18 at 6 hours, 0.60±1.65 at 12 hours, 0.40±1.19 at 18 hours, 0.16±0.62 at 24 hours, 0.08±0.4 at 30 hours & 36 hours, at 42 and 48 hours were 0 for group A. For group B values calculated were 2.20±2.58 at baseline, 1.40±1.55 at 6 hours, 1.28±1.72 at 12 hours, 0.76±1.56 at 18 hours, 0.28±0.61 at 24 hours and at 30, 36, 42 and 48 hours were 0. The intergroup comparison between group A and group B by independent t-test at various intervals revealed no statistically significant difference between two groups in mean VAS (p>.05) that means both the drugs are equally efficacious in relieving post-operative pain. Only 1 patient (4%) in group A experienced nausea. A total of 4 patients in group B had side effects, all 4 patients (16%) had heart burn, 2 out these 4 also complains of pain abdomen and 1 patient (4%) had vomiting. Conclusion: Flupirtine could be a better alternative to opioids and NSAIDs in postoperative pain relief