Document Detail


Sequential clot strength analyses following diclofenac in pediatric adenotonsillectomy.
MedLine Citation:
PMID:  17897274     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tonsillectomy is a common pediatric surgical procedure resulting in significant postoperative pain. There is ongoing controversy as to the most satisfactory analgesic regimen. Nonsteroidal antiinflammatory drugs (NSAIDs) are an alternative to opioids in this setting. NSAID use in tonsillectomy has been shown to be opioid sparing in the recovery period and to have similar analgesic effects to opioids in pediatric patients. Because of their nonspecific action on the enzyme cyclo-oxygenase there is potential for increased bleeding which has led many practitioners to avoid NSAIDs completely in this patient population potentially resulting in suboptimal pain control. Our aim in this study was to assess the effect of preoperatively administered diclofenac on the blood clot strength in children undergoing (adeno-) tonsillectomy. METHODS: Twenty patients undergoing (adeno-) tonsillectomy were recruited into this prospective observational study. All patients received 2 mg.kg(-1) of diclofenac rectally immediately preoperatively. Blood was taken for thromboelastograph analysis pre-diclofenac and 1 and 4 h post-diclofenac administration. RESULTS: There was a statistically significant increase in maximal clot strength (MA) at 1 and 4 h after diclofenac. Similarly there was a statistically significant reduction in time to initial fibrin formation (R time) post-diclofenac. There was no primary or secondary hemorrhage. CONCLUSIONS: Diclofenac when given preoperatively does not adversely affect clot strength in the immediate postoperative period when the risk of primary hemorrhage is greatest.
Authors:
Mairead Heaney; Yvonne Looney; Caleb McKinstry; Brendan O'Hare
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  17     ISSN:  1155-5645     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-09-27     Completed Date:  2008-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  1078-82     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Critical Care Medicine, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adenoidectomy*
Adenoids / surgery*
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage,  adverse effects*
Blood Coagulation / drug effects,  physiology
Child, Preschool
Diclofenac / administration & dosage,  adverse effects*
Humans
Preoperative Care / methods
Prospective Studies
Thrombelastography / drug effects*
Time Factors
Tonsillectomy*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 15307-86-5/Diclofenac

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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