Diclofenac and flurbiprofen with or without clonidine for postoperative analgesia in children undergoing elective ophthalmological surgery

We conducted a prospective, randomized study to compare the efficacy of pre operative diclofenac, flurbiprofen, and clonidine, given alone, as well as the combination of diclofenac and clonidine, and flurbiprofen and clonidine in controlling postoperative pain in 125 children. The patients (ASA I, 2- 12 years) undergoing elective ophthalmological surgery were allocated to on e of five groups: rectal. diclofenac 2 mg.kg(-1) following oral placebo pre medication, i.v. flurbiprofen 1 mg.kg(-1) following placebo premedication, oral clonidine premedication, rectal diclofenac 2 mg.kg(-1) following cloni dine, and i.v. flurbiprofen 1 mg.kg(-1) following clonidine. The children r eceived clonidine (4 mug.kg(-1)) or placebo 105 min before anaesthesia. Dic lofenac or flurbiprofen was given immediately after induction of anaesthesi a. Anaesthesia was induced and maintained with sevoflurane and nitrous oxid e in oxygen. Postoperative pain was assessed by a blinded observer using a modified objective pain scale (OPS). No opioids were administered throughou t the study. Rectal diclofenac 2 mg.kg(-1) i.v. flurbiprofen 1 mg.kg(-1), o ral clonidine 4 mug.kg(-1) provided similar OPS scores and requirement for supplementary analgesics during 12 h after surgery. Combination of oral clo nidine and one of these nonsteroidal analgesics minimized postoperative pai n. Our findings suggest that this combined regimen may be a promising proph ylactic approach to postoperative pain control in children undergoing ophth almological surgery.