title: Tube placement: a prospective, randomized double-blind study.
abstract: Bilateral myringotomy with tympanostomy tube placement is the second most frequently performed pediatric surgical procedure, next to circumcision. Postoperative pain relief for children undergoing this procedure has been an ongoing concern. The authors undertook a prospective, randomized, double-blind, placebo-controlled clinical study in 200 consecutive children to investigate the efficacy of oral acetaminophen, acetaminophen with codeine, ibuprofen, and placebo administered preoperatively in relieving postoperative pain in children undergoing this procedure. All children received topical analgesia consisting of antibiotic eardrops mixed with 4% lidocaine intraoperatively. There was no significant difference in postoperative pain score between the four groups (P > 0.4447). Thus it is likely that the intraoperative administration of antibiotic eardrops mixed with 4% lidocaine is all that is required to alleviate postoperative pain in children undergoing myringotomy with tympanostomy tube placement. Preoperative oral analgesics are apparently of little added benefit.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, Eastern Virginia Medical School, Norfolk 23507, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Derkay
authors.forename: J T
authors.initials: JT
authors.lastname: Wadsworth
authors.forename: D H
authors.initials: DH
authors.lastname: Darrow
authors.forename: B
authors.initials: B
authors.lastname: Strasnick
authors.forename: G K
authors.initials: GK
authors.lastname: Thompson
authors.forename: J
authors.initials: J
authors.lastname: O'Master
mesh_terms: D000779:Anesthetics, Local; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008876:Middle Ear Ventilation; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D014432:Tympanic Membrane / Q000601:surgery
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine