Subcutaneous injection of diclofenac for the treatment of pain following minor orthopedic surgery (DIRECT study): a randomized trial

325 patients scheduled to undergo a minor orthopaedic surgery were randomized to receive either intramuscular diclofenac hydroxypropyl-b-cyclodextrin, subcutaneous diclofenac hydroxypropyl-b-cyclodextrin, or intramuscular Voltaren for postoperative analgesia. This was done to compare safety and efficacy of postoperative analgesic treatments. Pain, measured through a visual analog scale (VAS), and local tolerability were among the outcomes measured. Results indicated that patients in the subcutaneous diclofenac hydroxypropyl-b-cyclodextrin who experienced injection site pain, experienced significantly greater pain than patients in other groups. There were no other significant differences between groups in safety or efficacy outcomes.