Abstract

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.