The effect of ketoprofen on recovery after tonsillectomy in children: a 3-week follow-up study.
OBJECTIVE
To evaluate recovery after tonsillectomy in children, and to determine the safety and efficacy of ketoprofen in pain treatment after discharge.


METHODS
A prospective, longitudinal study in 102 children undergoing tonsillectomy.


METHODS
All children underwent tonsillectomy under a same general anesthesia. At discharge, all patients were prescribed ketoprofen capsules at a dose of 3-5 mg(-1) kg(-1) per 24 h for postoperative pain control at home, with paracetamol or paracetamol-codeine tablets for rescue analgesia. At home, the patients recorded pain and analgesic consumption each day for the first week after surgery. At 3 weeks, patients recorded the total analgesic requirement, duration of pain, and all adverse events during recovery and return to normal daily activities.


RESULTS
The median of pain cessation was 9 days (range 1-20 days) and the median duration of analgesic treatment was 10 days (4-19 days). More than 50% of the patients needed rescue analgesic daily during the first week after tonsillectomy. Ketoprofen combined with paracetamol or paracetamol-codeine provided sufficient analgesia for most children. However, the analgesic action of drugs was too short to achieve pain relief, which allow undisturbed sleep during the first postoperative nights. A return back to normal daily activities took place after 9 days (2-26 days). The influence of age for pain pattern was negligible. Five patients needed electrocautery to stop postoperative bleeding. No other serious adverse-events occurred.


CONCLUSIONS
The main problem after tonsillectomy is significant pain that may last 9 days or longer after surgery. Ketoprofen combined with paracetamol-codeine seems to provide a sufficient analgesia, but before ketoprofen may be recommended for children during tonsillectomy a larger study is needed to show whether or not ketoprofen increases the hemorrhage rate.
Salonen
Aarre
A
Department of Otorhinolaryngology, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland.
Kokki
Hannu
H
Nuutinen
Juhani
J
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; 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; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007660:Ketoprofen / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology*; D011446:Prospective Studies; D020127:Recovery of Function / Q000187:drug effects*; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects*; D014069:Tonsillitis / Q000601:surgery*
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D007660:Ketoprofen; D003061:Codeine