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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
PubMed

Insights

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.
Abstract

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