A B-vitamin mixture reduces the requirements of diclofenac after tonsillectomy: A double-blind study

Pain observed after tonsillectomy is often severe and frequently requires the use of opioid analgesics. Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the need or avoid the use of opioids, but gastrointestinal side effects may limit their use. Sparing analgesic agents may reduce the requirement for NSAIDs and consequently their toxicity. It has been proposed that a B-vitamin mixture produces analgesia in experimental pain models. The present study was carried out to establish if a B-vitamin mixture was additive with the NSAID, diclofenac, in the treatment of postquirurgic pain. Two groups of 20 subjects, participated in the study. Group 1 received a B-vitamin mixture infusion for 12 h before the tonsillectomy, whereas Group 2 received vehicle. Both groups received a 50-mg diclofenac i.v. 8 h before surgery. Two hours after tonsillectomy, Group 1 received another B-vitamin mixture infusion for 12 h and Group 2 again received vehicle. Pain intensity was evaluated by a visual analog scale (VAS). Then diclofenac (50 mg i.v.) was administered as required by the patient without exceeding 150mg daily. Diclofenac consumption was recorded and VAS was evaluated for 54 h. Group 1 exhibited a lower pain intensity 2 h after tonsillectomy. Both groups showed similar analgesia. However, diclofenac consumption was approximately 30% lower in the group treated with the B-vitamin mixture. These results indicate that B vitamins can spare the use of analgesic agents.