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Preoperative rectal diclofenac versus paracetamol for tonsillectomy: effects on pain and blood loss

Schmidt, A; Björkman, S and Åkeson, Jonas LU (2001) In Acta Anaesthesiologica Scandinavica 45(1). p.48-52
Abstract
BACKGROUND: Diclofenac is widely used for postoperative analgesia but the perioperative safety of this drug is controversial because of its effect on platelet aggregation, which might increase blood loss. In a prospective investigator-blinded study the effects of diclofenac and paracetamol on pain and blood loss were compared in patients undergoing tonsillectomy. METHOD: Ninety patients were randomised to receive rectal diclofenac 0.65-1.0 mg x kg(-1) or paracetamol 13-20 mg x kg(-1) preoperatively. Ten patients were excluded after randomisation. Pain was evaluated postoperatively by means of the visual analogue scale and by recording the use of pethidine for rescue analgesia. Perioperative blood loss was estimated from measured... (More)
BACKGROUND: Diclofenac is widely used for postoperative analgesia but the perioperative safety of this drug is controversial because of its effect on platelet aggregation, which might increase blood loss. In a prospective investigator-blinded study the effects of diclofenac and paracetamol on pain and blood loss were compared in patients undergoing tonsillectomy. METHOD: Ninety patients were randomised to receive rectal diclofenac 0.65-1.0 mg x kg(-1) or paracetamol 13-20 mg x kg(-1) preoperatively. Ten patients were excluded after randomisation. Pain was evaluated postoperatively by means of the visual analogue scale and by recording the use of pethidine for rescue analgesia. Perioperative blood loss was estimated from measured intraoperative blood loss; use of drugs to achieve haemostasis, and the incidence of reoperations. RESULTS: Anaesthetic or surgical managements did not differ between the groups, but a significantly longer period of surgery was found in the diclofenac group, 32+/-16 vs. 25+/-11 min (P = 0.024). Pain scores or pethidine consumption were not significantly different between the groups. Intraoperative blood loss was significantly larger in the diclofenac group, 1.9 (1.1-3.1) vs. 1.1 (0.7-2.0) ml x kg(-1) (P = 0.007). CONCLUSION: Preoperative rectal diclofenac offers no advantage over paracetamol with respect to postoperative analgesia in tonsillectomy patients but increases intraoperative blood loss. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
Analgesics: diclofenac, paracetamol, pain: postoperative, surgery: hemorrhage, tonsillectomy
in
Acta Anaesthesiologica Scandinavica
volume
45
issue
1
pages
48 - 52
publisher
Wiley-Blackwell
external identifiers
  • pmid:11152033
  • scopus:0035196952
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2001.450108.x
language
English
LU publication?
yes
id
93199efe-e94e-40f1-a05a-a96d44ba7732 (old id 1122166)
date added to LUP
2008-07-14 10:47:31
date last changed
2018-02-18 03:35:07
@article{93199efe-e94e-40f1-a05a-a96d44ba7732,
  abstract     = {BACKGROUND: Diclofenac is widely used for postoperative analgesia but the perioperative safety of this drug is controversial because of its effect on platelet aggregation, which might increase blood loss. In a prospective investigator-blinded study the effects of diclofenac and paracetamol on pain and blood loss were compared in patients undergoing tonsillectomy. METHOD: Ninety patients were randomised to receive rectal diclofenac 0.65-1.0 mg x kg(-1) or paracetamol 13-20 mg x kg(-1) preoperatively. Ten patients were excluded after randomisation. Pain was evaluated postoperatively by means of the visual analogue scale and by recording the use of pethidine for rescue analgesia. Perioperative blood loss was estimated from measured intraoperative blood loss; use of drugs to achieve haemostasis, and the incidence of reoperations. RESULTS: Anaesthetic or surgical managements did not differ between the groups, but a significantly longer period of surgery was found in the diclofenac group, 32+/-16 vs. 25+/-11 min (P = 0.024). Pain scores or pethidine consumption were not significantly different between the groups. Intraoperative blood loss was significantly larger in the diclofenac group, 1.9 (1.1-3.1) vs. 1.1 (0.7-2.0) ml x kg(-1) (P = 0.007). CONCLUSION: Preoperative rectal diclofenac offers no advantage over paracetamol with respect to postoperative analgesia in tonsillectomy patients but increases intraoperative blood loss.},
  author       = {Schmidt, A and Björkman, S and Åkeson, Jonas},
  issn         = {0001-5172},
  keyword      = {Analgesics: diclofenac,paracetamol,pain: postoperative,surgery: hemorrhage,tonsillectomy},
  language     = {eng},
  number       = {1},
  pages        = {48--52},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Preoperative rectal diclofenac versus paracetamol for tonsillectomy: effects on pain and blood loss},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2001.450108.x},
  volume       = {45},
  year         = {2001},
}