Efficacy and Safety of Transdermal versus Intravenous Diclofenac for Postoperative Analgesia in Pediatric Inguinal Surgeries: A Comparative Study

Abstract

Background: Postoperative pain management in pediatric inguinal surgeries requires effective, safe, and minimally invasive analgesia. This study compared the analgesic efficacy and safety of transdermal versus intravenous (IV) diclofenac in children aged 5 to 10 years undergoing inguinal surgeries.

Methods: An open-label, quasi-randomized trial enrolled 40 eligible children (ASA physical status 1 and 2), allocating them into two equal groups. Following surgery, Group 1 received a 100mg transdermal diclofenac patch, while Group 2 was administered 1 mg/kg IV diclofenac, repeated every 8 hours. Postoperative pain intensity was evaluated using the Visual Analog Scale (VAS) at 2, 4, 8, and 12-hour intervals.

Results: Demographic and surgical profiles were comparable across both groups. Mean VAS scores showed no statistically significant differences between the transdermal and IV groups at 2 hours (4.45±0.999 vs 3.75±1.118, p=0.44), 4 hours (1.85±0.745 vs 2.20±0.768, p=0.152), 8 hours (1.30±0.571 vs 1.30±0.470, p=1.000), and 12 hours (1.25±0.550 vs 1.15±0.489, p=0.547). The requirement for additional rescue analgesia was minimal and lacked significant difference (10% in the transdermal group vs. 5% in the IV group, p=1.000). Zero adverse reactions were reported in either cohort.

Conclusion: Transdermal diclofenac is as effective and safe as intravenous diclofenac for managing postoperative pain in pediatric inguinal surgeries. Given its non-invasive application and consistent drug release, the transdermal patch represents a practical and patient-friendly alternative.