Effect of intraoperative analgesia on children’s pain perception during recovery after painful dental procedures performed under general anaesthesia
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To investigate the possible effect of intraoperative analgesia, namely diclofenac sodium compared to acetaminophen on post-recovery pain perception in children undergoing painful dental procedures under general anaesthesia.
A double-blind randomised clinical trial.
A sample of 180 consecutive cases of children undergoing full dental rehabilitation under general anaesthesia in a private hospital in Saudi Arabia during 2013 was divided into three groups (60 children each) according to the analgesic used prior to extubation. Group A, children had diclofenac sodium suppository. Group B, children received acetaminophen suppository and Group C, the control group. Using an authenticated Arabic version of the Wong and Baker faces Pain assessment Scale, patients were asked to choose the face that suits best the pain he/she is suffering. Data were collected and recorded for statistical analysis.
Student’s t test was used for comparison of sample means. A preliminary F test to compare sample variances was carried out to determine the appropriate t test variant to be used. A “p” value less than 0.05 was considered significant.
More than 93 % of children had post-operative pain in varying degrees. High statistical significance was observed between children in groups A and B compared to control group C with the later scoring high pain perception. Diclofenac showed higher potency in multiple painful procedures, while the statistical difference was not significant in children with three or less painful dental procedures.
Diclophenac sodium is more potent than acetaminophen, especially for multiple pain-provoking or traumatic procedures. A timely use of NSAID analgesia just before extubation helps provide adequate coverage during recovery. Peri-operative analgesia is to be recommended as an essential treatment adjunct for child dental rehabilitation under general anaesthesia.
KeywordsAnalgesia Dental rehabilitation Post-operative pain
- Acs C, Drazner E. The incidence of pain and analgesic usage in children. J Dent Child. 1992;59:48–52.Google Scholar
- El Sheikh S, El Basha S, El Batawi H. Total dental care for children on dental chair under general anesthesia using Dexamethasone as useful adjunct. Kasr El Aini Med J. 2002;8(5):183–95.Google Scholar
- Gazal G, Bowman R, Worthington HV, Mackie IC. A double-blind randomized controlled trial investigating the effectiveness of topical bupivacaine in reducing distress in children following extractions under general anaesthesia. Int J Paediatr Dent. 2004;14(6):425–431.Google Scholar
- Schechter NL. The undertreatment of pain in children: an overview. Pedi Clin N Am. 1989;36(4):781–94.Google Scholar
- Staman NM, Townsend JA, Hagan JL. Discomfort following dental procedures for children. Ped Dent. 2013;35(1):52–4.Google Scholar
- Versloot J, Veerkamp JS, Hoogstraten J. Assessment of pain by the child, dentist and independent observers. Paediatr Dent. 2004;26:445–9.Google Scholar
- Wong D, Baker C. Pain in children: comparison of assessment scales. Paediatr Nurs. 1988;14:9–10.Google Scholar
- World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organization. 2001;79.4:373.Google Scholar