{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T13:59:07Z","timestamp":1773323947900,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2005,8,15]],"date-time":"2005-08-15T00:00:00Z","timestamp":1124064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> Breast cancer treatment with mastectomy and immediate breast reconstruction (IBR) is associated with intense pain in the primary post\u2010operative period. The present prospective, placebo\u2010controlled and double\u2010blind study aimed to evaluate the analgesic efficacy of diclofenac, a non\u2010steroid anti\u2010inflammatory drug (NSAID), in combination with paracetamol and opioids. This was done by 64\u2010h assessment of post\u2010operative pain intensity, opioid consumption, blood loss, nausea and tiredness.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> Fifty women selected for mastectomy and IBR with submuscular implants with or without axillary lymph node dissection (ALND) were randomized to receive diclofenac 50\u2003mg\u2003\u00d7\u20033 or placebo rectally in addition to oral paracetamol and intravenous opioids delivered using a patient\u2010controlled analgesia (PCA) technique.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> During the first 20\u2003h post\u2010surgery, patients who received diclofenac experienced significantly less pain when resting than those who received placebo. When moving, a non\u2010significant estimated difference in pain in favour of diclofenac was also noted. Opioid consumption during the first 6\u2003h post\u2010operatively was 34% less with diclofenac than with placebo. Means (SD) were 16.9 (10.3) mg and 25.6 (10.2) mg, respectively (<jats:italic>P\u2003=<\/jats:italic>\u20030.007). After 64\u2003h, the difference was no longer statistically significant. Post\u2010operative bleeding was significantly higher with diclofenac than with placebo (<jats:italic>P\u2003&lt;<\/jats:italic>\u20030.01). Nausea and tiredness did not differ between the groups.<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> The addition of NSAID to paracetamol and opioid\u2010PCA reduced opioid consumption and improved pain relief during the first 20\u2003h at rest but was not convincingly effective during mobilization. Post\u2010operative blood loss was higher with diclofenac.<\/jats:p>","DOI":"10.1111\/j.1399-6576.2005.00811.x","type":"journal-article","created":{"date-parts":[[2005,9,2]],"date-time":"2005-09-02T16:48:53Z","timestamp":1125679733000},"page":"1360-1366","source":"Crossref","is-referenced-by-count":54,"title":["Analgesic efficacy of diclofenac in combination with morphine and paracetamol after mastectomy and immediate breast reconstruction"],"prefix":"10.1111","volume":"49","author":[{"given":"M.","family":"Legeby","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Sandelin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Wickman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Olofsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,8,15]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1054\/brst.2001.0386"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0952-8180(96)00131-6"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1990.tb03603.x"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(05)70383-2"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1646976"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0952-8180(95)00168-9"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1997.tb04657.x"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/02844319850158598"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)00005-5"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/88.2.215"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03019866"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/88.2.199"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1990.tb14618.x"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/75.1.15"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200102000-00009"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200107000-00006"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1992.tb04209.x"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.2003.01727.x"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199905000-00032"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/87.1.36"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1399-6576.2005.00811.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1399-6576.2005.00811.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T16:16:20Z","timestamp":1696868180000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1399-6576.2005.00811.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,8,15]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2005,10]]}},"alternative-id":["10.1111\/j.1399-6576.2005.00811.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1399-6576.2005.00811.x","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,8,15]]}}}