Question

A 50 yr old pt. With renal insufficiency was recently operated for pyelolithotomy, which drug you will give for post op analgesia.

• A. Diclofenac sodium
• B. Naproxen
• C. Indomethacin
• D. Acetaminophen

Answer 1

The Correct Option is D

In the provided clinical scenario, we need to select an appropriate analgesic for a 50-year-old patient who is dealing with both renal insufficiency and is in the postoperative phase after a pyelolithotomy. Considering these medical conditions, the choice of analgesic is crucial to avoid exacerbating renal issues. Among the options given:

• Diclofenac Sodium
• Naproxen
• Indomethacin
• Acetaminophen

It's important to understand that:

• Diclofenac Sodium, Naproxen, and Indomethacin are non-steroidal anti-inflammatory drugs (NSAIDs) which can potentially worsen renal function due to their mechanism involving cyclooxygenase inhibition. This can lead to decreased prostaglandin synthesis, reducing renal blood flow and potentially worsening renal impairment.
• Acetaminophen, also known as paracetamol, does not have significant anti-inflammatory properties but is effective for pain relief and does not adversely affect renal function in the same way NSAIDs do. Therefore, acetaminophen is generally considered safer for pain management in patients with compromised renal function.

Given these considerations, Acetaminophen is the most appropriate choice for postoperative analgesia in this patient with renal insufficiency.