Advertisement

Effects of meclofenamate and acetaminophen on abdominal pain following tubal occlusion

  • Kou Chu Huang
    Affiliations
    Department of Anesthesiology and Obstetrics and Gynecology, University of Louisville School of Medicine Louisville, Kentucky USA

    the Department of Statistics, University of Kentucky Lexington, Kentucky USA.
    Search for articles by this author
  • Walter M. Wolfe
    Affiliations
    Department of Anesthesiology and Obstetrics and Gynecology, University of Louisville School of Medicine Louisville, Kentucky USA

    the Department of Statistics, University of Kentucky Lexington, Kentucky USA.
    Search for articles by this author
  • Kentaro Tsueda
    Correspondence
    Reprint requests: Kentaro Tsueda, M.D., Department of Anesthesiology, University of Louisville, Louisville, KY 40292.
    Affiliations
    Department of Anesthesiology and Obstetrics and Gynecology, University of Louisville School of Medicine Louisville, Kentucky USA

    the Department of Statistics, University of Kentucky Lexington, Kentucky USA.
    Search for articles by this author
  • Pippa M. Simpson
    Affiliations
    Department of Anesthesiology and Obstetrics and Gynecology, University of Louisville School of Medicine Louisville, Kentucky USA

    the Department of Statistics, University of Kentucky Lexington, Kentucky USA.
    Search for articles by this author
  • Kenneth F. Caissie
    Affiliations
    Department of Anesthesiology and Obstetrics and Gynecology, University of Louisville School of Medicine Louisville, Kentucky USA

    the Department of Statistics, University of Kentucky Lexington, Kentucky USA.
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      To test the hypothesis that the postoperative abdominal pain of tubal occlusion is mediated by prostaglandins, the effects of meclofenamate, a potent inhibitor of cyclooxygenase, on postoperative analgesia and incidence of abdominal pain were compared with those of acetaminophen, a weak inhibitor of prostaglandin activity. One hundred patients undergoing tubal occlusion under local anesthesia were studied. The patients were randomly divided into four equal groups: (1) control; (2) acetaminophen, 1300 mg; (3) meclofenamate, 100 mg; (4) meclofenamate, 200 mg. The fallopian tubes were occluded by electrocautery in 47 patients and by application of Falope rings in 53 patients. Both acetaminophen and meclofenamate provided substantial analgesia for 4 hours after the operation (p < 0.05). Meclofenamate reduced the incidence of abdominal pain by one half (p < 0.02), but acetaminophen did not. These results suggest that a portion of pain relief achieved by meclofenamate may be due to suppression of myosalpingian and/or myometrial contractions, a process mediated by prostaglandins.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Burney RG
        • Soni V
        Intraperitoneal local anesthetics for tubal ligation.
        Reg Anaesth. 1982; 7: 74
        • Spielman FJ
        • Hulka JF
        • Ostheimer GW
        • Mueller RA
        Pharmacokinetics and pharmacodynamics of local analgesia for laparoscopic tubal ligations.
        Am J Obstet Gynecol. 1983; 142: 821
        • Collier HOF
        • Sweatman WJF
        Anatagonism of fenamates of prostaglandin F and slow-reacting substance on human bronchial muscle.
        Nature. 1968; 210: 864
        • Vane JR
        Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs.
        Nature (New Biol). 1971; 231: 232
        • Flower KJ
        • Moncada S
        • Vane JR
        Analgesic-antipyretics and anti-inflammatory agents; drugs employed in the treatment of gout.
        in: Goodman LS Gilman A The pharmacological basis of therapeutics. MacMillan, New York1980: 682
        • Gowans JD
        Six-month, double blind comparison of sodium meclofenamate (Meclomen) with buffered aspirin in the treatment of rheumatoid arthritis.
        Curr Med Res Opin. 1981; 7: 384
        • Vastik-Fernandez J
        • Gimeno MF
        • Lima F
        • Gimeno AL
        Spontaneous motility and distribution of prostaglandins in different segments of human fallopian tubes.
        Am J Obstet Gynecol. 1975; 62: 125
        • Ogra SS
        • Kirton KT
        • Tomasi TB
        • Lippes J
        Prostaglandins in the human fallopian tube.
        Fertil Steril. 1974; 25: 250
        • Harper MJK
        • Coons LW
        • Radicke DA
        • Hodgson BJ
        • Valenzuella G
        Role of prostaglandins in contractile activity of the ampulla of the rabbit oviduct.
        Am J Physiol. 1980; 238: E157
        • Brodie BL
        • Casper RF
        Prostaglandins mediate postoperative pain in Falope ring sterilization.
        Am J Obstet Gynecol. 1985; 151: 175
      1. Lancet. 1980; 2: 1346
        • Reasbeck PG
        • Rice ML
        • Reasbeck JC
        Double-blinded controlled trial of indomethacin as an adjunct to narcotic analgesia after major abdominal surgery.
        Lancet. 1982; 2: 115
        • Chi IC
        • Cole LP
        Incidence of pain among women undergoing laparoscopic sterilization by electrocoagulation, the spring-loaded clip, and the tubal ring.
        Am J Obstet Gynecol. 1979; 135: 397
        • Baggish MS
        • Lee WK
        • Mino SJ
        • Dacko L
        • Cohen G
        Complications of laparoscopic sterilization. Comparison of two methods.
        Obstet Gynecol. 1970; 54: 54
        • Larsen KE
        • Kaalund Jensen H
        Laparoscopic sterilization with Falope-ring: preoperative and late complications, method safety and a randomized investigation of immediate postoperative abdominal pain.
        Acta Obstet Gynecol Scand. 1983; 62: 125
        • Winder CV
        • Wax J
        • Welford M
        Anti-inflammatory and antipyretic properties of N-(2,6-dichloro-m-tolyl) anthranilic acid (CI-583).
        J Pharmacol Exp Ther. 1965; 148: 422