Abstract      Background: To compare the efficacy of rectal Diclofenac sodium suppository with orally administered Tramadol for relief of perineal pain following vaginal delivery. Objective: To determine the efficacy of Diclofenac rectal suppository and oral Tramadol tablets for perineal pain relief following vaginal delivery. Materials and Methods: In this randomized control cross sectional study, 300 subjects were divided in two groups. Group A (150 subjects) received rectal Diclofenac sodium suppositories and Group B (150 subjects) received oral Tramadol tablets. First suppository was inserted immediately after episiotomy suturing, and second offered 12-24 hours after first dose if the lady complained of pain still. Women in group B were given oral Tramadol tablets 0 and 8 hourly. Women were evaluated for pain relief using validated short form of McGill pain questionnaire, Wong-Baker facial pain rating scale and numeric pain rating scale. Results: There was statistically significant difference between the two groups for sensory, affective and total pain scores at rest or with movement after 24 hours of childbirth indicating rectal suppository was superior to oral tramadol tablets. Pain scores were significantly lower in Diclofenac sodium suppository group (p value ≤ .0001) when compared to Tramadol group. The difference was not sustained 48 hours after birth. Conclusion: The use of rectal Diclofenac sodium suppositories is simple, faster acting, effective and safe method of reducing the perineal pain experienced by women following normal vaginal delivery within 24 hours of normal vaginal delivery.

Keywords: Diclofenac sodium suppository, Tramadol, perineal pain, vaginal delivery, Pain scoring.