Analgesic efficacy and safety of preoperative versus postoperative ketorolac in paediatric tonsillectomy

Rømsing, Janne; Østergaard, Doris; Walther-Larsen, S; Valentin, N.

doi:10.1111/j.1399-6576.1998.tb05320.x

Cited by 61 publications

(52 citation statements)

References 19 publications

(14 reference statements)

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“…A dose of 1 mg/kg Ϫ1 has been found to be an effective analgesic for children. 13,14 Despite this finding, the time to requirement of first analgesic was shorter in both opiate groups. We found a higher incidence of postoperative vomiting in children given meperidine for intraoperative analgesia.…”

Section: Discussionmentioning

confidence: 88%

Anesthetic techniques and postoperative emesis in pediatric strabismus surgery

Chhabra¹,

Pandey

Khandelwal

et al. 2005

Regional Anesthesia and Pain Medicine

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Section: Discussionmentioning

confidence: 88%

Anesthetic techniques and postoperative emesis in pediatric strabismus surgery

Chhabra¹,

Pandey

Khandelwal

et al. 2005

Regional Anesthesia and Pain Medicine

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“…Elhaki and Nafie 6 showed that intravenous tenoxicam before induction of anesthesia reduced postoperative opioid consumption after Cesarean section. A recent report by Rømsing et al 7 also demonstrated that, for tonsillectomy, preoperative intravenous ketorolac reduced the postoperative use of fentanyl more than postoperative administration. In contrast, Buggy et al 8 showed that administration of diclofenac i m prior to laparoscopic tubal ligation produced no additional benefit compared with postoperation administration.…”

Section: Resultsmentioning

confidence: 99%

“…5 The preemptive efficacy of NSAIDs is controversial: not all studies have reported benefit. [5][6][7][8] We investigated whether flurbiprofen iv, given in a preemptive manner, reduce postoperative pain after abdominal hysterectomy .…”

mentioning

confidence: 99%

Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy

Nakayama

Ichinose

Yamamoto

et al. 2001

Can J Anesth/J Can Anesth

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GENERAL ANESTHESIAPurpose: To assess whether perioperative intravenous administration of flurbiprofen, a non-steroidal anti-inflammatory drug, reduced postoperative pain after abdominal hysterectomy.Methods: Forty-five patients undergoing abdominal hysterectomy were randomly assigned to one of three groups of equal size. A control group (CONT) received a placebo 30 min before and at the end of surgery. The other two groups, PRE and POST, received 1 mg·kg -1 flurbiprofen iv 30 min before and at the end of surgery, respectively. All patients received identical general and epidural anesthesia. Postoperatively, 50 mg diclofenac pr was given for pain relief on patient demand. One of the authors assessed pain using a 10 cm visual analog scale at rest and during coughing at the first request for diclofenac, and at 15, 24, 48, and 72 hr after surgery. The number of times diclofenac was required during the first 24 hr after surgery was also recorded.Results: The number of diclofenac requests in the PRE (1.8 ± 0.4) and POST groups (2.0 ± 0.4) were less than in the CONT group (3.0 ± 0.4). The PRE group showed lower visual analog scale at rest at 15 and 24 hr and on coughing at 24, 48, and 72 hr after surgery than the CONT and POST groups.Conclusion: Intravenous 1 mg·kg -1 flurbiprofen administered during anesthesia reduces postoperative rescue analgesic requirement after abdominal hysterectomy. Moreover, flurbiprofen is more effective when given before than after surgery.Objectif : Vérifier si l'administration intraveineuse périopératoire de flurbiprofène, un anti-inflammatoire non stéroïdien, réduit la douleur postopératoire d'une hystérectomie abdominale.Méthode : Quarante-cinq patientes devant subir une hystérectomie abdominale ont été réparties au hasard en trois groupes égaux. Un groupe témoin (TEM) a reçu un placebo, 30 min avant et à la fin de l'opération. Les deux autres groupes, PRE et POST, ont reçu 1 mg·kg -1 de flurbiprofène iv 30 min avant et à la fin de l'intervention, respectivement. Toutes les patientes ont reçu une anesthésie générale et épidurale identique. Après l'intervention, 50 mg de diclofénac pr ont été administrés sur demande comme analgésie. Un des auteurs a évalué la douleur en utilisant une échelle visuelle analogique de 10 cm, au repos et pendant la toux à la première demande de diclofénac et, puis à 15, 24, 48 et 72 h après l'opération. On a aussi noté le nombre de demandes de diclofénac pendant les 24 premières heures postopératoires.

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“…Both acetaminophen and ibuprofen are absorbed rapidly from gastrointestinal tract when administered orally. Twenty seven to 60 minutes after acetaminophen absorption and 54 to 90 minutes after ibuprofen absorption, they reach to their peak plasma levels (27). In this study, drugs were administered 30 minutes before the operation; therefore, acetaminophen had reached its peak of plasma level but ibuprofen had not.…”

Section: Discussionmentioning

confidence: 99%

The Analgesic Efficacy of Preoperative Oral Ibuprofen and Acetaminophen in Children Undergoing Adenotonsillectomy: A Randomized Clinical Trial

et al. 2014

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Background:Adenotonsillectomy is one of the most common surgical procedures in children. Several complications and morbidities are common after nasal surgeries and the most common is pain. Several techniques have been employed to reduce the severity of postoperative pain. One of the preoperative techniques is pre-emptive analgesia through preventive central hypersensitization. This technique is performed by applying analgesic methods before the onset of nociceptive stimuli, consequently decreasing postoperative analgesics requirements.Objectives:Preoperative oral drug administration for pain analgesia is performed in several methods. The aim of this study was to compare the analgesic effects of preoperatively administration of oral acetaminophen and ibuprofen.Patients and Methods:In a double-blinded, randomized placebo-controlled study, sixty 4-12 years old ASA I or II children scheduled for elective adenotonsillectomy, were assigned to receive either acetaminophen 15 mg/kg, ibuprofen 10 mg/kg or placebo 30 minutes before the operation. Postoperative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), upon arrival to the post anesthetic care unit (PACU) and ward. Findings were analyzed by SPSS version 17 using variance analysis and Tukey’s test.Results:The average pain intensities were significantly lower in acetaminophen group based on the CHEOPS in both PACU and ward compared to ibuprofen or placebo groups; but there was no difference in pain intensity between the ibuprofen and placebo groups. Pain intensity in PACU in Acetaminophen group was 7.05 ± 0.64 vs. 8.38 ± 1.20 in placebo group and 8.14 ± 0.85 in ibuprofen group, pain intensity in ward in the acetaminophen group was 6.0.87 ± 0.85in the acetaminophen group, vs. 8.04 ± 1.02 in placebo group, and 7.78 ± 0.78 in ibuprofen group.Conclusions:This study showed that administration of oral acetaminophen 30 minutes preoperatively, resulted in significantly lower pain intensity in children undergoing adenotonsillectomy in PACU and ward, compared to ibuprofen and placebo.

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Analgesic efficacy and safety of preoperative versus postoperative ketorolac in paediatric tonsillectomy

Abstract: This study indicates that a single dose of ketorolac 1 mg.kg-1 i.v. administered either before or immediately after surgery improves postoperative analgesia in children after tonsillectomy without evidence of increased incidence of bleeding.

Cited by 61 publications

References 19 publications

Anesthetic techniques and postoperative emesis in pediatric strabismus surgery

Anesthetic techniques and postoperative emesis in pediatric strabismus surgery

Perioperative intravenous flurbiprofen reduces postoperative pain after abdominal hysterectomy

The Analgesic Efficacy of Preoperative Oral Ibuprofen and Acetaminophen in Children Undergoing Adenotonsillectomy: A Randomized Clinical Trial

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