Rectal indomethacin for analgesia after appendicectomy in children

A prospective randomised controlled trial comparing rectal indomethacin with placebo was performed in children. Thirty children aged seven years and over undergoing open appendicectomy were given suppositories of either indomethacin 2 mg/kg or placebo. Suppositories were given at the conclusion of surgery and again 12 and 24 hours later. All children were given morphine by a patient-controlled analgesia pump. After 36 hours, children given indomethacin had used 0.51 (SD 0.34) mg/kg, and children given placebo 0.91 (SD 0.46) mg/kg (P < 0.02). Pain scores measured with a visual analogue scale, sedation scores and the incidence of vomiting were similar in both groups. Children given indomethacin suppositories used 44% less morphine than children given placebo, and at the same time obtained similar postoperative analgesia.