Eremostachys Laciniata as Effective as Rectal Diclofenac Suppository in Cesarean section Pain Relief: A Triple-Blind Controlled Clinical Trial

Abstract

Abstract Background: Pain and distress are two common complications of cesarean section (CS). Various pharmaceutical and complementary therapies have been employed to control CS pain. Among complementary therapies, Eremostachys was introduced as a pain mitigator. This study aimed at investigating the effect of Eremosthachys laciniata (EL) on CS pain and distress. Materials and Methods: This randomized clinical trial was conducted on 86 women with CS . In this study, the control group received 50 mg rectal diclofenac suppository every 8 hours for three days, and the intervention group received 35 mg EL total extract suppository every 8 hours up to three doses. The qualified women filled out demographic and midwifery questionnaires at baseline. Pain was measured with the Visual Analogue Scale (VAS) at 8, 16, and 24 hours after CS, and, before and 15 minutes after prescribing analgesics. Perceived distress questionnaire completed before and 24 hours after the intervention . The Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) Scale was completed 5 days after CS, and the side events checklist was filled out during the study. The data were analyzed through the Friedman, Chi-square and Wilcoxon and U- Mann Whitney tests. Findings: Two groups were not significantly different in terms of socio-demographic characteristics. Based on the Mann-Whitney U test, pain score at 8, 16, and 24 hours after surgery (15 min after intervention) was not significantly different between the intervention and control groups. In addition, 24-hour post-cesarean distress score based on Mann-Whitney U test showed no significant difference between the two groups (P = 0.440). There was a significant difference between the two groups in wound healing score (p=0.001), which indicated better efficacy of rectal diclofenac suppository than EL suppository. According to the frequency of data, there was no statistically significant difference in satisfaction between the two groups (P = 0.321). No side events were observed in two groups. Conclusion: Rectal EL suppository could be introduced as a low-complication, appropriate and effective medication in controlling pain and distress after CS, which was not much effective in wound healing.