Oral non-steroidal anti-inflammatory drugs for perineal pain in the early postpartum period

Single dose of non-steroidal anti-inflammatory drugs (NSAID) appear to be effective for perineal pain in the early postpartum period compared to placebo.

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and unclear blinding of outcome assessment).

Summary

A Cochrane review included 28 studies with a total of 4181 women (none of whom were breastfeeding). Great variety of non-steroidal anti-inflammatory drugs (NSAID) and different doses were used (ibuprofen, diclofenac, ketoprofen, diflunisal, flurbiprofen, meclofenamate, aceclofenat, dipyrone, etodolac, aspirin). Compared to women who received a placebo, more women who received a single dose NSAID achieved adequate pain relief at four hours (low-quality evidence) and at six hours, and were also less likely to need additional analgesia (table ). NSAIDs were more effective than paracetamol for adequate pain relief at four hours (RR 1.54, 95% CI 1.07 to 2.22; 3 studies, n=342) but not at six hours post-administration. There was no difference in the need for additional analgesia between the two groups at four hours in one study, but women in the NSAID group were less likely to need any additional analgesia at six hours.

Clinical comments

Date of latest search: 31 March 2016

Ədəbiyyat

1. Wuytack F, Smith V, Cleary BJ. Oral non-steroidal anti-inflammatory drugs (single dose) for perineal pain in the early postpartum period. Cochrane Database Syst Rev 2016;(7):CD011352.