Tawalbeh M I, Nawasreh O O, Husban A M
Prince Rashid Ben Al-Hassan Hospital, Al-Husn, Jordan.
Saudi Med J. 2001 Feb;22(2):121-3.
To compare the analgesic efficacy of diclofenac sodium and paracetamol on post adenotonsillectomy postoperative pain and oral intake.
Between January 1999 and July 2000, 80 children aged 3-14 years, underwent tonsillectomy and adenoidectomy for either recurrent tonsillitis or adenotonsillar hypertrophy in Prince Zeid Ben Al-Hussein Hospital and Prince Rashid Ben Al-Hussein Hospital. Forty-one children received diclofenac sodium suppositories (1-3mg/kg) postoperatively, whereas 39 children received only paracetamol syrup (10-15 mg/kg) in 4 divided doses. All children were observed for postoperative pain, oral intake, vomiting, temperature and complications.
Children who received diclofenac sodium had significantly less pain, less elevation of temperature, more oral intake, and started drinking significantly sooner than the paracetamol group. Two children in the diclofenac group experienced nausea and vomiting compared to 12 children in the paracetamol group in the first day. The time to first solid intake was significantly earlier in the diclofenac sodium group (p < 0.0001). With regard to complications, one patient in each group developed secondary hemorrhage, one child developed otitis media in the 2nd group. Each group had one readmission, and 2 children from the paracetamol group had an emergency department visit for pain and dehydration.
Diclofenac sodium has a significant effect on decreasing the pain associated with swallowing postoperatively and on the general condition of the patient. Improved oral intake resulted in a lower incidence of nausea and vomiting and allowed safer and earlier hospital discharge.
比较双氯芬酸钠和对乙酰氨基酚对腺样体扁桃体切除术后疼痛及经口进食情况的镇痛效果。
1999年1月至2000年7月，80名3 - 14岁儿童在扎伊德·本·侯赛因王子医院和拉希德·本·侯赛因王子医院因复发性扁桃体炎或腺样体扁桃体肥大接受扁桃体切除术和腺样体切除术。41名儿童术后接受双氯芬酸钠栓剂（1 - 3mg/kg），而39名儿童仅接受对乙酰氨基酚糖浆（10 - 15mg/kg），分4次服用。观察所有儿童的术后疼痛、经口进食情况、呕吐、体温及并发症。
接受双氯芬酸钠的儿童疼痛明显减轻，体温升高幅度较小，经口进食量更多，开始饮水的时间明显早于对乙酰氨基酚组。双氯芬酸钠组有2名儿童在第一天出现恶心和呕吐，而对乙酰氨基酚组有12名儿童出现。双氯芬酸钠组首次摄入固体食物的时间明显更早（p < 0.0001）。关于并发症，每组各有1例患者发生继发性出血，第二组有1名儿童发生中耳炎。每组各有1例再次入院，对乙酰氨基酚组有2名儿童因疼痛和脱水到急诊科就诊。
双氯芬酸钠对减轻术后吞咽相关疼痛及患者总体状况有显著效果。经口进食情况改善导致恶心和呕吐发生率降低，并使患者能更安全、更早出院。
