ANALGESIA

Abstract

Pain following tonsillectomy in childrenis a significant problem that tends to be underestimated. Nonsteroidal anti-inflammatory drugs are effective in themanagement of mild to moderate post-operative pain in children. They can decrease or even eliminate the need foropioid analgesia, thus reducing the opioid-induced side effects. In this study, I used paracetamol alone and acombination of paracetamol with either mefenamic acid or ibuprofen and examined the analgesia produced by all thesethree regimens by using Wong and Baker facial pain scale. Patients and method: The study comprised of three groupsA, B, and C (50 patients in each group selected by non probability convenient method and randomly divided). Analgesiawas achieved in group A with paracetamol 20mg/kg, with paracetamol 20mg/kg plus mefenamic acid 10mg/kg in groupB and paracetamol 20mg/kg plus ibuprofen 5mg/kg in group C orally in syrup form. Post-operative pain was assessedby Wong & Baker faces pain scale at recovery, 4, 8, 12 and 24 hours. Supplementary analgesia was given with oralmefenamic acid (10 mg/kg) in-group B and ibuprofen (5mg/kg) in-group C; otherwise regular oral paracetamol (20mg/kg-6 hourly) was given routinely in all three-study groups post-operatively. Results: Pain score was significantlyhigher in paracetamol group as compared to mefenamic acid or ibuprofen groups (P<0.05), however there was nosignificant difference in pain scores between mefenamic acid and ibuprofen groups. Conclusion: Although there is stillneed for improving analgesia for tonsillectomy pain in children but I can acclaim that a combination of mefenamic acidor ibuprofen with paracetamol is still the most useful, cheap and safe strategy in children, which avoids all opioids sideeffects.