Comparative study between the effect of Diclofenac and Ketorolac in post-tonsillectomy pain management

Abstract

Introduction: Tonsillectomy is one of the most common surgical procedures performed in children. It is associated with significant pain Ketorolac and Diclofenac are the commonly used NSAIDS for post-tonsillectomy pain; however, they may cause bleeding. Objective: To compare between the effect of diclofenac sodium and ketorolac in post-tonsillectomy pain management and bleeding. Materials and methods: 100 children aged 6-12 years were divided into two groups; Diclofenac group (n=50 patients who received diclofenac sodium analgesia) and Ketorolac group (n= 50 patients who received ketorolac tromethamine analgesia). Intra-operative and postoperative blood loss was assessed using the following scale for bleeding assessment (0 = no bleeding, 1 = bleeding as usual, 2 = bleeding more than usual, 3 = profuse, 4 = excessive, and lastly 5 = excessive and continuous), while postoperative pain was assessed using the verbal rating scale, the total consumption of additional analgesics used in each group and the time needed to restore normal dietary habits Results: There were no statistical differences between the two groups regarding intraoperative and postoperative bleeding. On the other hand, there was no statistical difference between the two groups regarding postoperative pain management. Forty-eight and forty-six patients returned to their normal dietary habits in the first day post-operative in diclofenac group and ketorolac group respectively. Conclusions: Both ketorolac and diclofenac administered intraoperatively before the start of surgery and continued postoperatively, both drugs effectively and equally controlled post-tonsillectomy pain with no serious adverse effects.

Efficacy of bupivacaine infiltration for controlling post‑tonsillectomy pain, duration of surgery and post‑operative morbidities: A systematic review and meta‑analysis

“…Tonsillectomy is a common surgical intervention (1)(2)(3). It involves the complete or partial removal of the palatine tonsils primarily to prevent recurring infections and inflammation (4,5).…”