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Acetaminophen plus ibuprofen versus opioids for treatment of post-tonsillectomy pain in children.

Abstract：

OBJECTIVE:To determine the efficacy and safety of acetaminophen plus ibuprofen in treatment of post-tonsillectomy pain compared to acetaminophen plus opioids in children. STUDY DESIGN:Retrospective medical record review. SETTING:Tertiary-care children's hospital between September 2012 and March 2013. SUBJECTS AND METHODS:All children undergoing total tonsillectomy (n=1065). Analysis included descriptive analysis, chi-square testing, and logistic regression controlling for age, diagnosis, trainee involvement, concurrent surgical procedures, and Coblator use for differences of outcomes: (1) post-operative bleeding, (2) emergency department (ED) visits for pain, dehydration, or bleeding, and (3) nurse phone calls from families. RESULTS:All patients received acetaminophen. Seventy-four percent received ibuprofen (n=783) and 26.5% did not receive ibuprofen (n=282). In the ibuprofen group, 32.2% received opioids (n=252). Over eight percent of children had post-operative hemorrhage of any amount reported (n=89). Forty-eight percent of these required operative intervention (n=43). Ibuprofen prescription did not impact post-operative bleeding; operative intervention for bleeding, ED visits, or nurse phone calls either on chi-squared or logistic regression testing. Increasing age was found to increase bleeding risk as well as the likelihood of visiting the ED or calling the clinic nurses. All patients with multiple bleeding episodes were in the ibuprofen group. CONCLUSION:Prescription of ibuprofen did not increase the risk of bleeding and did not increase the likelihood of a post-operative ED visit or nurse phone call. Ibuprofen prescription may possibly increase the risk of multiple bleeding episodes, but further prospective studies are needed. Increased age increases the risk of bleeding, ED visits, and nurse phone calls.

journal_name

Int J Pediatr Otorhinolaryngol

journal_title

International journal of pediatric otorhinolaryngology

authors

Mattos JL,Robison JG,Greenberg J,Yellon RF

doi

10.1016/j.ijporl.2014.07.017

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

1671-6

issue

10

eissn

0165-5876

issn

1872-8464

pii

S0165-5876(14)00406-6

journal_volume

78

pub_type

杂志文章

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