British Journal of Anaesthesia, Vol 82, Issue 1 56-60, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
P. Tarkkila and L. Saarnivaara
We have compared the analgesic and opioid sparing effect of three i.v.
non-steroidal anti-inflammatory drugs with placebo in a randomized,
double-blind, placebo-controlled study in 80 adult patients after elective
tonsillectomy. A standard anaesthetic was used. After induction of
anaesthesia, patients received ketoprofen 100 mg, diclofenac 75 mg or
ketorolac 30 mg by i.v. infusion over 30 min. Patients in the placebo group
received saline. Ketoprofen and diclofenac infusions were repeated after 12
h and ketorolac infusion at 6 h and 12 h. Oxycodone was used as rescue
analgesic. Patients in the ketoprofen group requested 32% less opioid and
patients in the diclofenac and ketorolac groups 42% less opioid than those
in the placebo group (P < 0.05). There were one, two and six patients in
the placebo, diclofenac and ketorolac groups, respectively, but none in the
ketoprofen group, who did not request opioid analgesia during the study (P
< 0.05, ketorolac vs placebo and ketoprofen). Visual analogue pain
scores were similar in all groups. Visual analogue satisfaction scores were
significantly higher in the diclofenac group compared with the placebo
group. The incidence of nausea was 44-54%. There were no differences in the
incidence of other adverse reactions. We conclude that all three
non-steroidal anti-inflammatory drugs were superior to placebo after
tonsillectomy.
CLINICAL INVESTIGATIONS
Ketoprofen, diclofenac or ketorolac for pain after tonsillectomy in adults?
Department of Anaesthesia, Otolaryngological Hospital, Helsinki University Central Hospital, Haartmaninkatu 4 E, FIN-00290 Helsinki, Finland
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