British Journal of Anaesthesia, Vol 82, Issue 5 715-717, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
N. S. Morton and K. O'Brien
We studied 80 children, aged 5-13 yr, who received PCA with morphine after
appendicectomy using a standardized tracheal general anaesthetic. All
patients received morphine 0.1 mg kg-1 before surgical incision and all had
wound infiltration with bupivacaine 1 mg kg-1 at the end of surgery.
Patients were allocated randomly to receive postoperative analgesia with
PCA morphine alone, morphine plus diclofenac 1 mg kg-1, morphine plus
paracetamol 15-20 mg kg-1 or morphine plus a combination of both diclofenac
and paracetamol. Cumulative morphine consumption was significantly reduced
by concurrent administration of diclofenac but no additive effect of
paracetamol was demonstrable with the doses used in the study. Analgesia,
as assessed by movement pain scoring, was significantly improved by the
addition of diclofenac despite lower morphine consumption. Adverse effects
and duration of PCA were comparable in the four groups.
CLINICAL INVESTIGATIONS
Analgesic efficacy of paracetamol and diclofenac in children receiving PCA morphine
Department of Anaesthesia, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK
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