Post Tonsillectomy Analgesia in Children with Paracetamol

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Sebha University
Background: Pain, regardless of site can affect nearly every organ functions, and adversely influences postoperative morbidity and mortality. This study designed to compare the analgesic effect of paracetamol suppositories and intravenous formulas, theoretically delayed absorption and sub therapeutic plasma concentration can be avoided by giving drugs (Paracetamol) intravenously. Patients and methods: Prospective study, was done on 120 children aged between 6-10 years (73 females and 47 males), ASA class 1 and 2. All were subject to elective tonsillectomy. Patients were classified randomly into 2 groups. Group (A): They received paracetamol intravenously 15 mg/kg after induction of anesthesia. Group B: They received paracetamol suppositories 30 mg/kg after induction of anesthesia. In all standard anaesthesia were used. Postoperatively pain scale using the visual analogue scale assessed for each patient, the incidence of using opioids and the incidence of nausea and vomiting were measured. Results: Patients in group A were in slightly better analgesia in the first few hours postoperatively than those in group B and this supported by the statistical significant results (P<0.05) .Furthermore, The incidence of using rescue opioids and the incidence of nausea and vomiting are higher in group B than that in group A. However, they are not statistically significant (P>0.05). Conclusion: Intravenous paracetamol is more effective in post tonsillectomy pain management in paediatric than the suppositories.
Paracetamol, visual analogue scale, tonsillectomy, opioids, nausea and vomiting.