The Effects of topical viscous lignocaine 2% versus per-rectal diclofenac in early post-tonsillectomy pain in children

Hardy, Mohamad Zaini Rhendra; Zayuah, Mat Sulaiman; Abdullah, Baharudin; Aasim, W.A. Wan; Shamsul, Kamaruljan Hassan; Ismail, Hashimah; Suan, Yang Ai

doi:10.1016/j.ijporl.2010.01.005

Cited by 11 publications

(10 citation statements)

References 24 publications

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“…No significant differences in meperidine use were noted over 24 h except at the 2-h postoperative time point, where the difference favored topical lidocaine (lignocaine). This study found no difference in pain scores between the two groups; no safety outcomes were reported [52]. The remaining trials of diclofenac tested the NSAID as part of a multimodal analgesic therapy and did not assess outcomes related to opioid consumption.…”

Section: Diclofenacmentioning

confidence: 85%

“…Four studies in our review examined pediatric use of diclofenac and are summarized in Table 4. All of these studies were conducted in children undergoing tonsillectomy [49][50][51][52], and two of them reported opioid-sparing outcomes. Öztekin et al [50] evaluated preoperative diclofenac 1 mg/kg compared with no preemptive analgesic in the background of PCA analgesia and found morphine consumption decreases of 23% in the post-anesthesia care unit (p = 0.012) and 42% on the ward (p = 0.021) compared with no preemptive treatment.…”

Section: Diclofenacmentioning

confidence: 99%

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Pain Management in Children: NSAID Use in the Perioperative and Emergency Department Settings

Cooney

2021

Pediatr Drugs

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used for pediatric pain management in the emergency setting and postoperatively. This narrative literature review evaluates pain relief, opioid requirements, and adverse effects associated with NSAID use. A PubMed search was conducted to identify randomized controlled trials evaluating the use of conventional systemic NSAIDs as pain management for children in the perioperative or emergency department (traumatic injury) setting. Trials of cyclooxygenase-2 inhibitors ("coxibs") were excluded. Search results included studies of ibuprofen (n = 12), ketoprofen (n = 5), ketorolac (n = 6), and diclofenac (n = 4). NSAIDs reduced the opioid requirement in 10 of 13 studies in which this outcome was measured. NSAID use did not compromise pain relief; NSAIDs provided improved or similar pain scores compared with opioids (or other control) in 24 of 27 studies. Adverse event frequencies were reported in 26 studies; adverse event frequencies with NSAIDs were lower than with opioids (or other control) in three of 26 studies, similar in 21 of 26 studies, and more frequent in two of 26 studies. Perioperative and emergency department use of NSAIDs may reduce opioid requirements while maintaining pain control, with similar or reduced frequencies of opioid-associated adverse events.

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Section: Diclofenacmentioning

confidence: 85%

Section: Diclofenacmentioning

confidence: 99%

Pain Management in Children: NSAID Use in the Perioperative and Emergency Department Settings

Cooney

2021

Pediatr Drugs

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“…Two drugs combination caused less pain after surgery but, there was no significant difference between the effects of diclofenac, and paracetamol. Some other studies also investigated the effect of diclofenac on pain after tonsillectomy surgery or other surgeries, all of which indicated the pain relieving effect of diclofenac and that less opioid consumption was required after surgery (17-19). These results confirmed the results of the current study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy

2012

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BackgroundTonsillectomy is a common procedure causing considerable postoperative pain. Postoperative pain intensity of 60 - 70 in the scale of visual analog scale (VAS) has been reported up to 3 - 4 days which could continue until 11 days after the surgery.ObjectivesThe current study aimed to compare the analgesic effect of gabapentin and diclofenac on pain after tonsillectomy with the control group.Patients and MethodsIn this double-blind, placebo-controlled clinical trial, 90 patients aged 10-25 years, ASA classes I and II were randomly selected to receive 20 mg/kg oral gabapentin (n = 30), 1.0 mg / kg rectal diclofenac (n = 30) or placebo (n = 30) preoperatively. Pain was evaluated postoperatively on a visual analogue scale at 2, 6, 12 and 24 h. Opioid consumption in the first 24 h after surgery and the side effects were also recorded.ResultsThere was no significant difference in terms of age, sex, and time of surgery in the three groups. Patients in the gabapentin and diclofenac groups had significantly lower pain scores at all-time intervals than those in the placebo group. The total meperidine consumed in the gabapentin (14.16 ± 6.97 P = 0.001) and diclofenac (16.66 ± 8.95, P = 0.004) groups was significantly less than that of the placebo (33.4 ± 13.97) group. The frequency of side effects such as vomiting, dizziness, and headache was not significantly different among the groups.ConclusionsIt can be concluded that gabapentin and diclofenac reduced postoperative pain and opioid consumption without obvious side effects.

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“…Adequate postoperative pain management is a chief goal in all operations. Although many studies were concerned with the post-tonsillectomy pain management and these studies have studied different routes, drugs, and mechanisms for pain management, for example, intravenous, intramuscular, rectal, and local infiltration (Moss et al 2014;Rhendra et al 2010;Heidari et al 2012), it still represents a clinical dilemma and challenge for the anesthetist to get pain-free child after tonsillectomy operation. As tonsillectomy surgery is considered one of the shared airway operations, so post-tonsillectomy analgesia requires a nonsedating, nonrespiratory depressing analgesic that can be used in an outpatient setting to allow early mobilization and return to regular function.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies were concerned with the post-tonsillectomy pain management. These studies studied different routes, drugs, and mechanisms for pain management-for example, intravenous, intramuscular, rectal, and local infiltration (Moss et al 2014;Rhendra et al 2010;Heidari et al 2012). In contrast, post-tonsillectomy analgesia requires a unique choice to be a nonsedating, nonrespiratory-depressing analgesic that can be used in an outpatient setting to allow early mobilization and return to regular function.…”

Section: Introductionmentioning

confidence: 99%

The prophylactic effect of rectal diclofenac versus intravenous pethidine on postoperative pain after tonsillectomy in children

Saleh

Hassan

2019

Ain-Shams J Anesthesiol

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Background: Postoperative pain in children is common after tonsillectomy. Rectal diclofenac has been used effectively for postoperative pain management in small children. Aim: To evaluate the prophylactic effect of rectal diclofenac versus intravenous pethidine on postoperative pain management in children undergoing tonsillectomy. Methods: This was a prospective, double-blinded randomized study. A total of 100 children, aged 3-10 years, American Society of Anesthesiologists status I or II, and scheduled for elective tonsillectomy or adenotonsillectomy, were recruited for the study. Patients were randomized to receive either rectal diclofenac 2 mg/kg (group A) or intravenous pethidine 0.5 mg/kg (group B) after induction of general anesthesia. The postoperative pain was assessed using Face, Legs, Activity, Cry, and Consolability scale for the first 6 h. The need for rescue analgesic, rectal paracetamol 40-60 mg/kg, was recorded also after surgery. Moreover, estimation of sedation using Ramsay sedation scale was assessed. Postoperative complications considering mainly vomiting and respiratory depression were recorded. Data were statistically described in terms of mean ± SD, median and range, or frequencies (number of cases) and percentages when appropriate. Results: Pain scores were significantly lower in diclofenac group at different times and needed less rescue analgesic. Postoperative sedation and vomiting were significantly higher in pethidine group. Respiratory depression occurred only in pethidine group. Conclusion: Prophylactic rectal diclofenac is effective in reducing pain after adenotonsillectomy and postoperative analgesic requirement. Moreover, it is generally safe.

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The Effects of topical viscous lignocaine 2% versus per-rectal diclofenac in early post-tonsillectomy pain in children

Cited by 11 publications

References 24 publications

Pain Management in Children: NSAID Use in the Perioperative and Emergency Department Settings

Pain Management in Children: NSAID Use in the Perioperative and Emergency Department Settings

Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy

The prophylactic effect of rectal diclofenac versus intravenous pethidine on postoperative pain after tonsillectomy in children

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