COMPARATIVE EFFICACY OF DICLOFENAC SODIUM VERSUS COMBINATION OF PARACETAMOL AND IBUPROFEN FOR ACUTE POSTOPERATIVE TONSILLECTOMY PAIN: A RANDOMISED CONTROL STUDY
DOI:
https://doi.org/10.22270/ijmspr.v1i2.5Keywords:
Tonsillectomy, Diclofenac sodium, Paracetamol, IbuprofenAbstract
Pain is a significant hindrance to the rehabilitation of a patient following tonsillectomy. This necessitates the need for adequate pain control to avoid poor oral intake, delayed recovery and prolonged hospitalization. The objective of the study is to compare the analgesic effect of Diclofenac sodium alone and combination of Paracetamol and Ibuprofen in controlling post tonsillectomy pain.The study also compares improvement in post tonsillectomy pain in patients above and below 15 years of age andto determine the duration of analgesic required. This is a Randomized Control study conducted in a tertiary care center. The study which spanned over a period of 6 months included 68 post tonsillectomy patientsin the age group of 5 to 30 years who were randomly allocated into two groups. One group was subjected to oral Diclofenac sodium while the other received a combination of Paracetamol and Ibuprofen. The study concluded that combining two analgesics for pain improvement in post tonsillectomy patients appears to be more effective, requires lesser dosage of individual drugs and causes lesser side effects than single drug therapy. With appropriate dosage of analgesics, post- tonsillectomy morbidity can be significantly reduced, reducing the duration of therapy in all age groups
References
Curatolo M and Sveticic G (2002), “Drug combinations in pain treatment—a review of the published evidence and a method for finding the optimal combination”, Best Pract Res Clin Anaesthesiol., Vol. 16, pp. 507– 19. 7
Demeules J, Rollasen V, Piguet V and Dayer P (2003),“Clinical pharmacology and rationale of analgesic combinations”, Eur J Anaesthesiol Suppl., Vol. 28, pp.7–12.
Lange H, Kranke P, Steffen P, Steinfeldt T, Wulf H and Eberhart L H (2007)”Combined analgesics for postoperative pain therapy. Review of effectivity and side-effects”, Anaesthesist, Vol. 56, pp. 1001–16.
Marcelle Macnamara (2008), ”Acute and Chronic pharyngeal infection, Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery”, 7th edition, Vol. 2, pp. 1981-2024.
Mehlisch D R (2002), “The efficacy of combination analgesic therapy in relieving dental pain”, J Am Dent Assoc., Vol. 133, pp. 861–71.
Merry A and Power I (1995), ”Perioperative NSAIDs: towards greater safety”, Pain Rev, Vol. 2, pp. 268-91.
Morton N S (1999), “Prevention and control of pain in children”, Br J Anaesth, Vol. 83, pp. 118-29.
Ong C K S, Lirk P, Tan C H, Seymour R A (2007), “An evidence-based update on nonsteroidal anti-inflammatory drugs”, Clin Med Res., Vol. 5, pp.19–34.
Ong C K S and Seymour R A (2008), “An evidence-based update of the use of analgesics in dentistry”, Periodontal 2000, Vol. 46, pp.143–64.
Rafa R B (2001), “Pharmacology of oral combination analgesics: rational therapy for pain”, J Clin Pharm Ther., Vol. 26, pp. 257–64.
Rakesh S, Anand T S, Payal G and Pranjal K A (2012), “A prospective, randomized, double-blind study of coblation versus dissection tonsillectomy in adult patients”, Indian J Otolaryngol Head Neck Surg., Vol. 64, pp.290-4.
Romsing J et al. (1998), ”Examination of acetaminophen for outpatient management of post-operative pain in children”, Paediatric anaesthesia, Vol. 8, No. 3, pp. 235-9.
Romsing J, Moiniche S and Dahl J B (2002), “Rectal and parenteral Paracetamol and Paracetamol in combination with NSAIDs, for postoperative analgesia”, Br J Anaesth, Vol. 88, pp. 215–26.
Seideman P (1993), “Additive effect of combined naproxen and Paracetamol in rheumatoid arthritis”, Br J Rheumatol., Vol. 32, pp.1077–82.
Sutters K A et al. (2004), “A randomized clinical trial of the effectiveness of a scheduled oral analgesic dosing regimen for the management of post-operative pain in children following tonsillectomy pain”, Vol. 110, Nos. (1-2), pp. 49-45.
Sutters K A and Miaskowski C (1997), “Inadequate pain management and associated morbidity in children at home after tonsillectomy”, Vol. 12, No. 3, pp.178-85.
William S Mckerrow and Ray Clarke (2008), “Tonsillectomy, Scott-Brown’s Otorhino laryngology, Head and Neck Surgery”, 7thedition, Vol.1, pp. 1229-41.
World Health Organization (1990), Cancer Pain Relief and Palliative Care: Report of a WHO Expert Committee, Geneva: World Health Organization, pp. 7–21
Published
How to Cite
Issue
Section
Copyright (c) 2015 Abhishek Sahu, Priti Hajare, Ramesh Mudhol, Anil Harugop, Amol Shiromony, Smrithi Menon, Monali Mitra

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

.