Analgesic Effects of Preoperative Versus Postoperative Tiaprofenic Acid in Pediatric Tonsillectomy & Adenoidectomy

Lee, Il Ok

Abstract

BACKGROUND
The aim of this study was to investigate the pre-emptive effect of preoperative intravenous tiaprofenic acid in children aged 4~11 years after tonsillectomy and adenoidectomy.
METHODS
We compared in 45 children the effect of preoperative with postoperative tiaprofenic acid (5 mg/kg) on pain after tonsillectomy and adenoidectomy, which was approved by Ethics Committee. Informed consents were obtained from all their parents. After induction of anesthesia, patients were allocated randomly to receive a tiaprofenic acid intravenously either before (n=15) or immediately after (n=15) surgery. The control group was received saline (n=15). Postoperative pain was rated on a faces scale for postoperative 48 hours. Tiaprofenic acid was given when patient complained pain. The cumulative pain score within 3 hours and 48 hours, time to the first analgesic administration, total requirement of analgesics for 48 hours and the first time of swallowing 50 ml water were checked.
RESULTS
Postoperative pain score of the preoperative group was significantly lower than the postoperative group at 9, 42, and 48 hours after operation. The cumulative pain scores during the first 3 hours were 15+/-4 (p <0.05 vs postoperative), 21+/-7 and 22+/-5 in pre, postoperative and saline groups respectively. The cumulative pain scores for 48 hours were 40+/-18 (p <0.05 vs postoperative), 61+/-17 and 63+/-18 in pre, postoperative and saline groups respectively. The times of the first swallowing were 6 (5~6)(p <0.05 vs postoperative) hours, 7 (6.7~9)hours, and 8 (4.5~8.7)hours after operation in pre, postoperative, and saline groups respectively.
CONCLUSIONS
Preoperative tiaprofenic acid in the tonsillectomy and adenoidectomy was effective on the reducing the intensity of the postoperative pain. The time to the first swallowing was shorter in the preoperative than postoperative group. The results of this study support the theory of pre-emptive analgesia.