BUPIVACAINE INFILTRATION VERSUS DICLOFENAC SUPPOSITORY FOR POST-TONSILLECTOMY PAIN RELIEF IN PAEDIATRIC PATIENTS

Abstract

Background: Pain management after tonsillectomy in children remains a dilemma for anaesthesiologist. The study was designed to compare the effect of pre-incisional infiltration of Bupivacaine (0.25%) versus Diclofenac suppository on postoperative pain relief in children.

Methodology: Fifty patients of American Society of Anaesthesiology grade – I, aged between 1 and 15 years undergoing elective tonsillectomy were selected. They were randomly divided equally into group A and B. Five minutes before incision, peritonsillar fossa were infiltrated with 5 ml Bupivacaine(0.25%) in group A patients. Group B received Diclofenac suppository 2mg/kg after induction. Intra operatively all patients were observed for vital parameters. Post-operatively all the patients were observed for 24 hours for analgesia using observer pain scale, analgesic requirement, vital data and other complications.

Result: Diclofenac suppository is a better option for post-operative analgesia in paediatric patients undergoing tonsillectomy as compared to bupivacaine infiltration as there were significant difference in pain score (P<0.05) after two hours onwards post operatively. Complications like bradycardia, hypotension, allergic reaction and convulsion were not found in either group.

Conclusion: Diclofenac suppository is a better option as compared to pre-incisional bupivacaine infiltration because of its convenience and duration of analgesia.