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Diclofenac for acute pain in children
Joseph F Standing1, Imogen Savage, Deborah Pritchard
1Pharmaceutical Biosciences, Uppsala Universitet, Division of Pharmacokinetics and Drug Therapy, Uppsala Universistet BMC Box 591, Uppsala, Sweden, 75124.
The Cochrane Database of Systematic Reviews
|October 13, 2009
Summary
Diclofenac effectively manages acute pain in children, reducing the need for rescue analgesia and decreasing nausea/vomiting. Serious adverse reactions are rare and similar to those in adults, though more research on dosing and asthmatic children is needed.
Area of Science:
- Pediatric Pharmacology
- Pain Management
- Evidence-Based Medicine
Background:
- Diclofenac is widely used for acute pain in pediatric populations.
- Its use is not universally licensed across all pediatric age groups for this indication.
Purpose of the Study:
- To evaluate the efficacy of diclofenac for treating acute pain in children.
- To assess the safety profile of short-term diclofenac administration in pediatric patients.
- To identify evidence gaps for future research directions.
Main Methods:
- A comprehensive search of 17 databases for clinical trial reports was conducted.
- Adverse reaction data from the UK Yellow Card Scheme and WHO were reviewed.
- Included studies involved pediatric patients (≤18 years) with acute pain, assessing efficacy or safety.
Main Results:
- Diclofenac significantly reduced the need for rescue analgesia compared to placebo (NNT 3.6).
- It was associated with less nausea or vomiting compared to non-NSAID treatments (NNT 7.7).
- Serious adverse reactions were infrequent (<0.24%) and comparable to adult profiles.
Conclusions:
- Diclofenac demonstrates efficacy as an analgesic for perioperative acute pain in children.
- Serious adverse reactions in children are rare and similar to those observed in adults.
- Further research is recommended for optimal dosing and safety in pediatric patients, particularly those with asthma.
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