Effect of intravenous diclofenac or indomethacin on the emergence from anaesthesia for tonsillectomy

Abstract

We evaluated the effects of a single dose of diclofenac (75 mg) or indomethacin (50 mg) on intraoperative events and on the early recovery phase. The study was performed in a randomised, double-blind, placebo-controlled fashion in 63 adult patients scheduled for elective tonsillectomy. Study infusions started intravenously immediately after the induction of general anaesthesia with thiopentone; maintenance was with N2O/O2 and halothane. After intubation with the aid of suxamethonium, the patients breathed spontaneously via a Bain coaxial system. Perioperative events (bleeding tendency, bleeding, need for pain medication, physical recovery) were recorded with the aid of a questionnaire applied to the anaesthesia nurses and estimation of vigilance, attention, concentration, short-term memory, and simple motor speed during recovery was with the aid of three neuropsychological tests (thumb tapping test, digit span test and homogenic interference test). No significant differences between the three groups were found in systolic and diastolic arterial pressures, the results of the questionnaire, and those of the neuropsychological tests. The ability to keep the head elevated for at least 5 s recovered significantly later (P < 0.05) and heart rate levels in the indomethacin group were significantly lower (P < 0.001) than in the other two groups. No enhanced bleeding during the perioperative period was observed. Diclofenac and indomethacin in the doses used in our study have only a marginal effect on the patient's emergence from anaesthesia.