COMPARISON OF DIFFERENT DOSES OF RECTAL PARACETAMOL WITH RECTAL DICLOFENAC AS PRE-EMPTIVE ANALGESIA FOR POSTOPERATIVE PAIN RELIEF IN CHILDREN UNDERGOING TONSILLECTOMY
Dr. Abdul Hakeem, Dr. Ghulam Ali, Dr. Gul Mohammad, Dr. Feroz Ahmad Dar*
ABSTRACT
Background: Rectal diclofenac is an excellent analgesic and is widely
used to treat acute postoperative pain in children but is associated with
side effects. Paracetamol being free of these side effects and is usually
well tolerated by children. Aims: Comparing the effectiveness of
different doses of rectal paracetamol with rectal diclofenac as preemptive
analgesia in tonsillectomy patients. Material and methods:
Study groups were divided into three groups, containing 20 patients in
each group. Group P50 received 50mg/kg rectal paracetamol, Group
P25 received 25mg/kg rectal paracetamol and Group D received rectal
diclofenac 1mg/kg half an hour before surgery. Patients evaluated at
different time intervals regarding post operative pain score
intraoperative and postoperative hemodynamic, recovery status after extubation and untoward
adverse effects. Results: Intraoperative heart rate and blood pressure at different time
intervals were stable in Group P50 and Group D as compared to group P25. The time of first demand of analgesic was
significantly delayed in Group P50 and Group D as compared to Group P25 (P<00.5). Pain
intensity recorded by using TPPPS scale of the three studied groups varied significantly at 15
minutes, 1 hour, 4 hours and at 8 hours after extubation (P<0.005). Total duration of
analgesia was significantly prolonged in Group P50 (657±9.94 mins) and Group D
(502±10.63 mins) as compared to Group P25 (288±23.17 mins) (p<0.005). Conclusion:
Preemptive rectal paracetamol 50mg/kg appears to be equally effective as rectal diclofenac
for postoperative analgesia in children undergoing tonsillectomy.
Keywords: Pre-emptive Analgesics, rectal, Paracetamol, Diclofenac, Tonsillectomy.
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