Double-Blind Controlled Trial of Indomethacin as an Adjunct to Narcotic Analgesia After Major Abdominal Surgery

A prospective randomised trial was undertaken to assess the efficacy of indomethacin as an analgesic after abdominal surgery. 44 patients received indomethacin suppositories (100 mg every 8 h for three days postoperatively) and 46 patients received placebo suppositories (every 8 h for the same period), in addition to intramuscular morphine (0.15 mg/kg every 4 h as required). Postoperative subjective pain assessments, analgesic requirements, and respiratory function were recorded. Patients receiving indomethacin required significantly fewer doses of morphine than those receiving placebo and has less pain on each of the first four postoperative days. The duration of postoperative morphine requirement was shorter for the indomethacin than for the placebo group. pCO2 on the first postoperative day was lower in the indomethacin group than the placebo group (4.82 +/- 0.08 vs 5.18 +/- 0.08 kPa). The administration of indomethacin in addition to morphine after major abdominal surgery provides better pain control than that provided by intramuscular morphine alone.