Comparing the Efficacy of Postoperative Diclofenac Suppository with Intramuscular Diclofenac in Children under going Inguinal Hernia Surgery

Ayesha Yaqeen ,Hafiza Sidra ,Maria Saeed

doi:10.7176/jmpb/65-05

Abstract

Objective: To compare the analgesic effect of postoperative Diclofenac suppository with intramuscular Diclofenac in children undergoing inguinal hernia surgery. Methodology: This study was held in Paeds Surgery Department, Nishtar Hospital Multan, Bahawal Victoria hospital Bahawalpur. from August 2018 to March 2019. Total no. of 160 patients were divided into two groups, one receiving diclofenac suppository group DS and the other which was group DI received intramuscular diclofenac injection. Numerical variables like age and weight were analyzed statistically by taking their mean and standard deviation while the outcome variable i.e. severity of pain was assessed through facial expressions as no pain, mild, moderate and severe pain in frequency percentage at 0, 2 and 4 hours interval. Results: Total 160 patients were divided into 2 groups equally, 80 in each (DS & DI). There was no significant difference in the efficacy of diclofenac suppository and diclofenac intramuscular when calculated at 0, 2 and 4 hours interval. When Chi-Square was applied to determine the association, it was observed that pain severity was significantly associated with age. But the association of pain severity with weight and with time intervals in two groups was not statistically significant. Conclusion: From this study we conclude that there is no significant difference between the postoperative analgesic effect of either suppository or intramuscular diclofenac but suppository route has an advantage over intramuscular in that it is easier and safer, less prone to injury, easy to administer and has longer duration of action, especially preferable in pediatric patients. Keywords: Children, diclofenac Sodium, inguinal Hernia, intramuscular, suppository DOI: 10.7176/JMPB/65-05 Publication date: April 30 th 2020

Highlights

The incidence of inguinal hernia is almost 80,000 children in world
Inguinal hernia is an indication of elective herniotomy(in children) herniorraphy(in adults), which prevents incarceration and subsequent strangulation
Patients were divided into two groups, one receiving diclofenac suppository (DS group) and the other group getting intramuscular diclofenac injection (DI group)

Summary

Introduction

The incidence of inguinal hernia is almost 80,000 children in world. It was found that the cumulative incidence of inguinal hernia from birth to 15 years of age was 0.74% in females and 6.62% in males {1,2}. While in the adult population almost all cases of sliding hernias are seen in men {3}. When obliteration of the processus vaginalis fails to occur, it results into inguinal hernia. Inguinal hernia is an indication of elective herniotomy(in children) herniorraphy(in adults), which prevents incarceration and subsequent strangulation. Multiple factors contributing to chronic pain include scrotal hernia, hernia repair or emergency recurrent hernia repair. Postoperative pain may be less with laparoscopic procedures as compared to open procedures {4}. Pain caused by tension or compression may slowly diminish with time as a consequence of tissue reorganization {5}

Methods

Results

Conclusion