Oral Non-Steroidal Anti-Inflammatory Drugs for Perineal Pain in the Early Postpartum Period

Summary

A Cochrane review [Abstract] 1 included 35 studies with a total of 5136 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 T1). 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.