Postoperative Pain Management in Children following (Adeno)Tonsillectomy: Efficacy, Pharmacokinetics and Tolerability of Paracetamol and Diclofenac

Authors: Peters J.W.B.¹; Vulto A.G.²; Grobee R.³; Meursing A.E.E.¹

Source: Clinical Drug Investigation, Volume 17, Number 4, 1 April 1999 , pp. 309-319(11)

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Abstract:

Concerns exist about the optimal analgesic for postoperative pain management following (adeno)tonsillectomy. Hence, we decided to review the efficacy of paracetamol (acetaminophen) and diclofenac in children aged 3 to 12 years after (adeno)tonsillectomy. Pharmacokinetics and adverse effects of the two agents were also addressed. A MEDLINE search (1966 to 1998), review articles and textbooks were used as data sources. In general, systematic and practice-based research on these drugs for this indication is scarce. Paracetamol 20 mg/kg administered orally, 60 minutes preoperatively, and diclofenac 2 mg/kg administered rectally at induction seem to achieve satisfactory analgesia in the majority of children during the first few hours postoperatively.

Keywords: Paracetamol, therapeutic-use; Diclofenac, therapeutic-use; Diclofenac, pharmacokinetics; Paracetamol, pharmacokinetics; Paracetamol, adverse-reactions; Diclofenac, adverse-reactions; Reviews-on-treatment; Postoperative-pain, treatment; Children; Clinical-pharmacokinetics; Analgesics, therapeutic-use; Oral; Rectal; Analgesics, pharmacokinetics; Analgesics, adverse-reactions

Document Type: Original article

Affiliations: 1: Department of Paediatric Anaesthesiology, Sophia Children's Hospital, Rotterdam, The Netherlands 2: Department of Pharmacy, University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands 3: Julius Centre for Patient Oriented Research, Utrecht University Hospital, Utrecht, The Netherlands

Publication date: 1999-04-01