A retrospective study of the effect of postoperative indomethacin rectal suppositories on the need for narcotic analgesia in patients who had a cesarean delivery while they were under regional anesthesia

Objective: This study was undertaken to assess the efficacy of rectal indomethacin as an analgesic after cesarean delivery, comparing narcotic usage in patients receiving indomethacin with patients who received only standard narcotic analgesics. Study Design: A retrospective study of patient records consisting of 297 women who underwent cesarean delivery while they were under regional anesthesia in a medium-sized community hospital from February 1996 through December 1999. Narcotic usage was determined as morphine equivalents whereby 10 mg morphine sulfate equals 30 mg oxycodone equals 50 mg hydrocodone equals 75 mg meperidine. Indomethacin was administered as 50-mg rectal suppositories. Statistical analysis was done by Pearson correlation and independent Student t test analysis. Results: Narcotic usage was reduced by an average of 16 morphine equivalents (28%) in the indomethacin group. Pearson correlation revealed correlation at the .01 level; independent Student t test analysis revealed a P value of .001. Thus the mean amount of narcotic analgesic administered was significantly less in patients treated with indomethacin rectal suppositories. Conclusion: In this uncontrolled trial the use of indomethacin rectal suppositories resulted in a significant reduction in narcotic use in the postcesarean hospital recovery period as measured in morphine equivalents. (Am J Obstet Gynecol 2001;184:1544-8.)