鼻内双氯芬酸钠、布洛芬和扑热息痛缓解小儿扁桃体切除术后疼痛

IF 1.3 4区 医学 Q3 OTORHINOLARYNGOLOGY
Alper Yenigun , Ramazan Bahadir Kucuk , Muhammed Furkan Ozgan , Harun Uysal , Ali Asram Sagıroglu , Vildan Betul Yeni̇gun , Orhan Ozturan
{"title":"鼻内双氯芬酸钠、布洛芬和扑热息痛缓解小儿扁桃体切除术后疼痛","authors":"Alper Yenigun ,&nbsp;Ramazan Bahadir Kucuk ,&nbsp;Muhammed Furkan Ozgan ,&nbsp;Harun Uysal ,&nbsp;Ali Asram Sagıroglu ,&nbsp;Vildan Betul Yeni̇gun ,&nbsp;Orhan Ozturan","doi":"10.1016/j.ijporl.2025.112552","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Postoperative pain following pediatric tonsillectomy remains a significant clinical challenge. Concerns about the efficacy and safety of current analgesics have prompted interest in intranasal (IN) delivery of nonsteroidal anti-inflammatory drugs (NSAIDs) as a non-invasive, effective alternative with minimal side effects.</div></div><div><h3>Methods</h3><div>In this prospective, randomized study, we evaluated the analgesic efficacy and safety of IN diclofenac sodium, IN ibuprofen, and IN paracetamol, compared to intravenous (IV) paracetamol, in children aged 2–14 years undergoing tonsillectomy. Sixty patients were randomized into four equal groups. Postoperative pain was assessed using the CHEOPS, VAS, and Wong-Baker modified VAS scores at multiple time points up to 12 h post-surgery. Data were analyzed using the Kruskal–Wallis and Dunn's tests.</div></div><div><h3>Results</h3><div>At 15 min postoperatively, IN diclofenac sodium and IN ibuprofen resulted in significantly lower pain scores compared to IV paracetamol (p &lt; 0.05). However, this difference was not sustained at later time points. Across most other intervals, pain scores in the IN NSAID groups were numerically lower, but these differences did not reach statistical significance. IN paracetamol was less effective than IV paracetamol at several time points. No serious adverse events, including bleeding, were observed.</div></div><div><h3>Conclusion</h3><div>IN diclofenac sodium and IN ibuprofen provided a transient reduction in early postoperative pain after pediatric tonsillectomy, with significantly lower pain scores at 15 min compared to IV paracetamol. At subsequent time points, the analgesic efficacy of IN NSAIDs was similar to that of IV paracetamol. The clinical relevance of this short-term benefit remains uncertain, and larger studies with additional outcome measures are warranted.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112552"},"PeriodicalIF":1.3000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intranasal diclofenac sodium, ibuprofen and paracetamol for pain relief after pediatric tonsillectomy\",\"authors\":\"Alper Yenigun ,&nbsp;Ramazan Bahadir Kucuk ,&nbsp;Muhammed Furkan Ozgan ,&nbsp;Harun Uysal ,&nbsp;Ali Asram Sagıroglu ,&nbsp;Vildan Betul Yeni̇gun ,&nbsp;Orhan Ozturan\",\"doi\":\"10.1016/j.ijporl.2025.112552\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>Postoperative pain following pediatric tonsillectomy remains a significant clinical challenge. Concerns about the efficacy and safety of current analgesics have prompted interest in intranasal (IN) delivery of nonsteroidal anti-inflammatory drugs (NSAIDs) as a non-invasive, effective alternative with minimal side effects.</div></div><div><h3>Methods</h3><div>In this prospective, randomized study, we evaluated the analgesic efficacy and safety of IN diclofenac sodium, IN ibuprofen, and IN paracetamol, compared to intravenous (IV) paracetamol, in children aged 2–14 years undergoing tonsillectomy. Sixty patients were randomized into four equal groups. Postoperative pain was assessed using the CHEOPS, VAS, and Wong-Baker modified VAS scores at multiple time points up to 12 h post-surgery. Data were analyzed using the Kruskal–Wallis and Dunn's tests.</div></div><div><h3>Results</h3><div>At 15 min postoperatively, IN diclofenac sodium and IN ibuprofen resulted in significantly lower pain scores compared to IV paracetamol (p &lt; 0.05). However, this difference was not sustained at later time points. Across most other intervals, pain scores in the IN NSAID groups were numerically lower, but these differences did not reach statistical significance. IN paracetamol was less effective than IV paracetamol at several time points. No serious adverse events, including bleeding, were observed.</div></div><div><h3>Conclusion</h3><div>IN diclofenac sodium and IN ibuprofen provided a transient reduction in early postoperative pain after pediatric tonsillectomy, with significantly lower pain scores at 15 min compared to IV paracetamol. At subsequent time points, the analgesic efficacy of IN NSAIDs was similar to that of IV paracetamol. The clinical relevance of this short-term benefit remains uncertain, and larger studies with additional outcome measures are warranted.</div></div>\",\"PeriodicalId\":14388,\"journal\":{\"name\":\"International journal of pediatric otorhinolaryngology\",\"volume\":\"198 \",\"pages\":\"Article 112552\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of pediatric otorhinolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0165587625003398\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of pediatric otorhinolaryngology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165587625003398","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的儿童扁桃体切除术后的疼痛仍然是一个重大的临床挑战。对现有镇痛药的疗效和安全性的担忧促使人们对鼻内给药(in)非甾体抗炎药(NSAIDs)作为一种无创、副作用最小的有效替代药物产生了兴趣。方法在这项前瞻性随机研究中,我们评估了双氯芬酸钠、布洛芬和扑热息痛在2-14岁接受扁桃体切除术的儿童中的镇痛效果和安全性,并与静脉注射扑热息痛进行了比较。60例患者随机分为4组。术后疼痛采用CHEOPS、VAS和Wong-Baker改良VAS评分在术后12小时多个时间点进行评估。数据分析使用Kruskal-Wallis和Dunn的测试。结果术后15 min双氯芬酸钠和布洛芬治疗组疼痛评分明显低于静脉注射扑热息痛组(p < 0.05)。然而,这种差异在后来的时间点没有持续下去。在大多数其他间隔中,非甾体抗炎药组的疼痛评分在数值上较低,但这些差异没有达到统计学意义。在几个时间点,内注射扑热息痛的疗效低于静脉注射扑热息痛。未观察到严重的不良事件,包括出血。结论双氯芬酸钠和布洛芬可短暂减轻儿童扁桃体切除术后早期疼痛,与静脉注射扑热息痛相比,15分钟疼痛评分明显降低。在随后的时间点,非甾体抗炎药的镇痛效果与静脉注射扑热息痛相似。这种短期获益的临床相关性仍然不确定,需要进行更大规模的研究,以获得更多的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intranasal diclofenac sodium, ibuprofen and paracetamol for pain relief after pediatric tonsillectomy

Objectives

Postoperative pain following pediatric tonsillectomy remains a significant clinical challenge. Concerns about the efficacy and safety of current analgesics have prompted interest in intranasal (IN) delivery of nonsteroidal anti-inflammatory drugs (NSAIDs) as a non-invasive, effective alternative with minimal side effects.

Methods

In this prospective, randomized study, we evaluated the analgesic efficacy and safety of IN diclofenac sodium, IN ibuprofen, and IN paracetamol, compared to intravenous (IV) paracetamol, in children aged 2–14 years undergoing tonsillectomy. Sixty patients were randomized into four equal groups. Postoperative pain was assessed using the CHEOPS, VAS, and Wong-Baker modified VAS scores at multiple time points up to 12 h post-surgery. Data were analyzed using the Kruskal–Wallis and Dunn's tests.

Results

At 15 min postoperatively, IN diclofenac sodium and IN ibuprofen resulted in significantly lower pain scores compared to IV paracetamol (p < 0.05). However, this difference was not sustained at later time points. Across most other intervals, pain scores in the IN NSAID groups were numerically lower, but these differences did not reach statistical significance. IN paracetamol was less effective than IV paracetamol at several time points. No serious adverse events, including bleeding, were observed.

Conclusion

IN diclofenac sodium and IN ibuprofen provided a transient reduction in early postoperative pain after pediatric tonsillectomy, with significantly lower pain scores at 15 min compared to IV paracetamol. At subsequent time points, the analgesic efficacy of IN NSAIDs was similar to that of IV paracetamol. The clinical relevance of this short-term benefit remains uncertain, and larger studies with additional outcome measures are warranted.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.20
自引率
6.70%
发文量
276
审稿时长
62 days
期刊介绍: The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信