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Diclofenac for acute pain in children
Cochrane Reviews, 10/08/09

Standing JF et al. – This review has found that, as with adults, diclofenac is effective for the relief of pain after an operation. If it is given at the time of an operation, it will halve the number of children needing extra pain relief. Diclofenac seems to be twice as effective as paracetamol (acetaminophen) for surgical pain, and this is also true for adults. Diclofenac appears to cause similar types of serious adverse reactions (such as bleeding of the stomach and allergic–type reactions), but these are rare and occur in fewer than 3 in 1000 children who take the drug. The authors had hoped to investigate whether diclofenac made children with asthma more wheezy, but there was not enough information for us to do this. The main conclusions of this review are that diclofenac is effective for relief of acute pain arising from operations in children, with a low risk of serious adverse reactions. Intramuscular injections of diclofenac should be avoided, due to risk of injection site problems. The main questions still to be answered are: What is the best dose to give and should diclofenac be avoided in children with asthma?

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