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Comparison of Single Dose Diclofenac Sodium Vs Paracetamol Suppository for Pain Relief Following Inguinal Surgery in Children

Deepak Paulose T , Ravindra Bhat R1 , Murugananth N2 , Vasudevan A3 , Hemavathy B4 , Deepak Paulose T5

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Indian Journal of Anesthesia and Analgesia 6(6):p 2013-2018, November-December 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.24

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Ravindra Bhat R, Murugananth N, Vasudevan A et al. Comparison of Single Dose Diclofenac Sodium Vs Paracetamol Suppository for Pain Relief Following Inguinal Surgery in Children. Indian J Anesth Analg. 2019;6(6 Part -I):2013-2018.

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Abstract

Context: Management of post-operative pain in children is challenging due to the side effects of the drugs like opioids and pain during intramuscular administration. Aims: To compare the quality of post-operative analgesia between rectally administered paracetamol and diclofenac as Assessed by Pain Discomfort Scale (APDS). Settings and Design: We compared the efficacy of pre-operatively administered rectal paracetamol 40 mg/kg and diclofenac 1 mg/kg. in 60 randomised children undergoing elective inguinal hernia surgeries. Materials and Methods: The patients were given general anesthesia with fentanyl for intra-operative pain relief. Post-operative pain was assessed using AIIMS Pain and Discomfort Scoring system (APDS) and the duration of analgesia was noted. Statistical analysis used: The difference between the Paracetamol and Diclofenac Group with respect to duration of analgesia, intra-operative fentanyl use and heart rate at awakening was compared using independent t-test. APDS score was compared using Mann Whitney’s test. A p-value < 0.05 was considered significant. Results: Intra-operative fentanyl requirement was similar in both the Groups. Post-operative pain scores were lower in Diclofenac Group. Duration of analgesia was longer in Diclofenac Group compared to Paracetamol Group (12.5 hrs vs 7.6 hrs). Three patients in Diclofenac Group had vomiting and gastritis. Conclusions: Better post-operative pain relief of 1 mg/kg of rectal diclofenac without significant bleeding makes it an attractive option for management of post-operative pain in children. However, anti-gastritis prophylaxis may be desirable to prevent the complications.

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Ravindra Bhat R, Murugananth N, Vasudevan A et al. Comparison of Single Dose Diclofenac Sodium Vs Paracetamol Suppository for Pain Relief Following Inguinal Surgery in Children. Indian J Anesth Analg. 2019;6(6 Part -I):2013-2018.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.24

Keywords

Rectal Diclofenac; Paracetamol; Post-operative Pain; Children.

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