The aim of the study was to evaluate the effects of using preemptive analgesia in children assigned to undergo tonsillectomy under general anesthesia and to compare the analgesic effect of two non-steroid antiinflammatory drugs (NSAIDs); namely diclophenac and tenoxicam versus that of paracetamol. In prospective double-blinded study. 75 ASA I children (3-8.5 years old) were randomly allocated to receive preemptive analgesia using rectal paracetamol (30 mg/kg), intramuscular diclophenac (1 mg /kg), and intravenous tenoxicam (0.75 mg / kg) 20 minutes prior to surgery. The efficacy of analgesia during the first 24 h postoperatively. was documented by an observational pain-discomfort scale (OPS) and by duration of analgesia till the first request of rescue analgesia (paracetamol suppository, 30 mg / Ica). The quality of postoperative pain relief despite being excellent in the three groups, was statistically superior with a signcant (P<0.05) prolongation of the duration in group C. Furthermore, there was a significant reduction (P<0.05) of both the number of patients required and the total dose of rescue analgesics consumed in groups B & C versus group A. Postoperative local bleeding was encountered in 2 patients, one in each of groups A & B. one required resuturing of a slipped ligature and the second responded to conservative treatment We can conclude that the preemptive analgesia improves the postoperative course after tonsillectomy, and the use of NSAIDs is more beneficial than paracetamol, |
