International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 3, Issue 5 | Original Research Article | Open Access DOI
Issar NK*
Dhiman P1, Grewal R2, Issar NK1*, Prasad AS1, Jain R1, Singh S1, Gupta R1, Vats A1, Koli J1, Kalra M1, Sharma N3, Jain H4 and Yadav AK5
1Department of Gastroenterology and Transplant Hepatology, Army Hospital (R&R), India
2Department of Anaesthesiology and Critical Care Command Hospital (CC), India
3Senior Resident, All India Institute of Medical Sciences, India
4Intern, Army Hospital (R&R), India
5Department of Internal Medicine, Army Hospital (R&R), Delhi, India
Fulltext PDF1.1. Introduction: There is not much data and studies till date on the use and efficacy of use of intramuscular injection diclofenac as an adjunct or sole antipyretic agent in adult febrile patients. This study reports the use, efficacy and adverse effects of a single IM injection of diclofenac sodium in adult patients with and without concomitant use of acetaminophen.
1.2. Materials and Methods
1.2.1. Type of study: Retrospective observational study
1.2.2. Population: Data of the adult patients presenting at Fever clinic and admitted during the period January 2022 to January 2024 with diagnosed and undiagnosed causes of fever were analyzed. Study subjects included adult patients with fever which was defined as an axillary temperature of 38 ℃ or higher. Patients having previous co morbidity like CAD, Diabetes mellitus, patients with sepsis requiring ionotropes and vasopressors or mechanical ventilator support, having kidney impairment in form of AKI or preexisting CKD, patients with CLD, having altered sensorium, patients on Corticosteroids and those having history of adverse reaction to any NSAID’s were excluded from the study. Data of total of 1102 patients were analyzed.
1.2.3. Protocol: Body temperature was measured at 30 min to 60 min intervals following Diclofenac sodium injection. Patients who were not on any antipyretic and who did not respond to usual dose of Acetaminophen (15 mg/kg - 30 mg/kg of the body weight in divided doses) were included in the analysis. Intramuscular Diclofenac sodium Dose 75 mg was given to patients presenting with fever with and without concomitant use of other anti-pyretic or NSAID’s.
1.3. Results: Fever alleviation could be achieved in 1058 out of 1102 patients by use of Diclofenac. The average time taken for antipyretic effect following administration of intramuscular diclofenac sodium was 39.1 min ± 23.8 min. The average time taken for antipyretic action was 33 min + 15.7 min for patients on concomitant antipyretics which was significantly less than 39.3 min + 17.2 min for those not on any antipyretics p value < 0.01. The average temperature reduction after 1 h was 1.2 ℃ ± 1.1 ℃ being greater for patients on antipyretics as compared to patients not on any other antipyretic being 1.1 ℃ ± 0.9 ℃. During the period of study and at end of 7 days, minor GI side effects were the most common and there were no reported major side effects.
1.4. Conclusion: A single dose of Intramuscular injection of diclofenac sodium provided effective antipyretic in the study population of the febrile adult patients. Diclofenac may be used alone or as an adjunct with antipyretics. No serious side effects were observed.
Fever; Adults; NSAID’s; Antipyretics; Injection diclofenac
Dhiman P, Grewal R, Issar NK, Prasad AS, Jain R, Singh S, et al. Single Intramuscular Injection of Diclofenac Sodium in Adult Febrile Patients. Int Clinc Med Case Rep Jour. 2024;3(6):1-7.