The effects of topical viscous lignocaine 2% versus per-rectal diclofenac in early post-tonsillectomy pain in children.
BACKGROUND
Tonsillectomy is frequently associated with postoperative pain of considerable duration, which is usually accompanied by the substantial consumption of both opioid and non-opioid analgesic such as NSAIDs and local anaesthetics.


OBJECTIVE
The aim of this study was to evaluate the efficacy between 2% viscous lignocaine and sodium diclofenac based upon the visual analogue scores (VASs), consumption of pethidine 0.5mgkg(-1) as the rescue drug postoperatively and time taken to resume feeding.


METHODS
130 patients aged between 5 and 12 years old were randomly allocated into 2 groups to be given either 2% viscous lignocaine 4mgkg(-1) body weight topically post-tonsillectomy or sodium diclofenac 1mgkg(-1) per-rectal post-induction of anaesthesia. Postoperatively visual analogues score was done for 24h, the amount of pethidine given and time when the patient start taking oral feeding of clear fluid, soft diet and normal diet were documented.


RESULTS
There was no significant difference in the visual analogue scores in both groups, however the requirement of pethidine as the rescue drug postoperatively was significant 2h post-tonsillectomy (p=0.023) in viscous lignocaine group compared to sodium diclofenac. The time taken to resume oral feeding and soft diet was also significant in viscous lignocaine group (p=0.016 and p=0.007) whereas there was no significant in taking normal diet.


CONCLUSIONS
We concluded that 2% viscous lignocaine applied topically post-tonsillectomy is comparable to sodium diclofenac per-rectal in providing analgesia and faster oral feeding.
Department of Anaesthesiology and Intensive Care, University Sains Malaysia Hospital, 16150, Kubang Kerian, Kelantan, Malaysia. rhendra@gmail.com
Mohamad Zaini
MZ
Rhendra Hardy
Mat Sulaiman
MS
Zayuah
Abdullah
A
Baharudin
Wan Adnan
WA
Wan Aasim
Kamaruljan Hassan
KH
Shamsul
Ismail
I
Hashimah
Yang Ai
YA
Suan
D000285:Administration, Rectal; D000287:Administration, Topical; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004008:Diclofenac / Q000627:therapeutic use*; D004363:Drug Utilization; D004435:Eating; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D014068:Tonsillectomy
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D008012:Lidocaine; D008614:Meperidine