Analgesia in tonsillectomy: a double-blind study on pre and post-operative treatment with diclofenac

Abstract

The efficacy and tolerability of diclofenac suppositories given pre and/or post-operatively were investigated in a randomized double-blind study on 99 patients undergoing tonsillectomy. In one group, 50 mg diclofenac was given 1 h preoperatively, followed by 50 mg directly after the operation. In another group, diclofenac 100 mg was given only immediately post-operatively. A significantly lower consumption of rescue analgesics (paracetamol and/or pethidine) was found in the group treated preoperatively with diclofenac and the average time until first demand of rescue analgesics was significantly longer compared to the group given diclofenac post-operatively only. The tolerance was good and no serious bleeding complications occurred in either group. In the treatment of post-operative pain after tonsillectomy, the combination of pre and post-operative administration of diclofenac suppositories resulted in significantly lower consumption of rescue analgesics and is thus preferable to administration solely post-operatively.

Effects of intramuscular and peritonsillar injection of tramadol before tonsillectomy: A double blind, randomized, placebo-controlled clinical trial

“…It aims to block the development of hypersensitivity and hyperalgesia and, thus, decrease postsurgical pain [4,[6][7][8]. Preemptive analgesia for tonsillectomy may be performed either by infiltration of local anesthetic to the peritonsillar region [9][10][11][12][13][14][15][16], or by giving analgesic agents before surgery [17,18].…”

Avaliação do efeito analgésico preemptivo do lumiracoxibe comparado com placebo nas primeiras 24 horas de pós-operatório

“…A diminuição acentuada no consumo de analgé-sicos no pós-operatório também é demonstrada na revisão sistemática de Romsing 25 , sendo que em um estudo há diminuição de 83% no consumo de analgésicos nas primeiras 24 horas 33 . Essas constatações vêm ao encontro aos resultados obtidos neste estudo, no qual ficou evidenciado aumento de 191 minutos no tempo para solicitação de analgésicos pela primeira vez e diminuição de 53% no consumo de tramadol nas primeiras 24 horas do pós-operatório.…”

A B-Vitamin mixture reduces the requirements of diclofenac after tonsillectomy: a double-blind study

“…Very often, management of pain after this surgery is inadequate, since side effects associated with the use of opioids, such as emesis, excessive sedation, and risk of respiratory depression, can limit their use. Due to the side effects of opioid drugs, it has been proposed that non-steroidal anti-inflammatory drugs (NSAIDs) can reduce or even eliminate the need for post-operative opioids [Nordbladh et al, 1991;Souter et al, 1994;Saarnivaara et al, 1980]. However, gastrointestinal or renal side effects can occur.…”