A prospective, randomised trial of preoperative rectal diclofenac: are we closing the gate after the horse has gone?
For patients undergoing varicose vein surgery preoperative administration of rectal diclofenac significantly improves post-operative analgesia and this effect is independent of whether it is given at induction or 30-45 minutes preoperatively.
This preliminary prospective study, though limited by small numbers, shows that 10/14 (71%) of stable patients with haemopericardium had unnecessary non-therapeutic sternotomy and could have safely been managed with SPW and drainage only. Further prospective, randomised studies are required to confirm the good outlook.