A comparison of ibuprofen versus acetaminophen with codeine in the young tonsillectomy patient.
OBJECTIVE
To compare the use of ibuprofen with the use of acetaminophen with codeine for posttonsillectomy management.


BACKGROUND
We were not satisfied with our traditional pain-management practice for tonsillectomy patients. We hoped to find a new approach for improved patient comfort and avoid scheduled, abusable drugs such as codeine.


METHODS
Intervention, prospective, randomized control trial. Follow-up was 1 month.


METHODS
University referral center; institutional pediatric practice, ambulatory.


METHODS
110 children undergoing tonsillectomy with or without other procedures. Consecutive patients were offered participation. Enrollees were randomly assigned to one of two classes and analyzed with the initial assignment. No patients withdrew for adverse effects, although 12 in group 2 used codeine and 5 of those used acetaminophen, whereas 2 in group 1 received ibuprofen.


METHODS
Patients received either acetaminophen with codeine (group 1) or ibuprofen (group 2) for postoperative pain control.


METHODS
The main outcomes, determined before initiation of the study, were assessment of (1) postoperative bleeding, (2) pain, (3) efficacy of relief of pain by drug, (4) nausea, (5) emesis, (6) readmission to hospital, (7) average temperature, and (8) highest temperature after surgery.


RESULTS
The only statistically significant difference is less nausea in patients receiving ibuprofen (p = 0.0049). Of note, no difference existed in postoperative bleeding, pain, or temperature control.


CONCLUSIONS
Ibuprofen is at least as effective as acetaminophen with codeine for postoperative pain control in children after tonsillectomy.
St Charles
C S
CS
Indiana University Medical Center, Indianapolis, USA.
Matt
B H
BH
Hamilton
M M
MM
Katz
B P
BP
D000082:Acetaminophen / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003061:Codeine / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005334:Fever / Q000188:drug therapy; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011183:Postoperative Complications / Q000188:drug therapy; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects*
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D000082:Acetaminophen; D003061:Codeine; D007052:Ibuprofen