title: A comparison of paracetamol, ibuprofen or their combination for pain relief following extractions in children under general anaesthesia: a randomized controlled trial.
abstract: OBJECTIVE
  This study was designed to compare the effectiveness of different oral analgesics for relieving pain and distress in children following the extraction of teeth under general anaesthesia (GA). The analgesics included paracetamol alone, ibuprofen alone, and paracetamol and ibuprofen in combination.
  
  
  METHODS
  Two hundred and one subjects were randomly allocated to one of four groups. Forty-seven children were included in the ibuprofen alone (5 mg kg(-1)) group, 51 in the paracetamol/ibuprofen combination (15/5 mg kg(-1)) group, 48 in the high-dose paracetamol (20 mg kg(-1)) group, and 55 children were included in the usual-dose paracetamol (15 mg kg(-1)) group (control group). Evaluation of distress for children was made immediately pre-operatively, on recovery from anaesthesia and again after 15 min by using a five-point face scale. Furthermore, each child was observed immediately postoperatively and 15 min postoperatively for signs of pain using the Children's Hospital of Eastern Ontario Pain Scale.
  
  
  RESULTS
  There were significant decreases in the mean pain and distress scores for both the ibuprofen alone and paracetamol/ibuprofen combination groups compared to the control group (usual-dose paracetamol) at 15 min postoperatively.
  
  
  CONCLUSIONS
  This study provides evidence to support the oral administration of ibuprofen alone or in combination with paracetamol for postoperative analgesia in children who are having teeth extracted under GA.
authors.affiliation: Unit of Paediatric Dentistry, School of Dentistry, University of Manchester, Manchester, UK.
authors.forename: Giath
authors.initials: G
authors.lastname: Gazal
authors.forename: Iain C
authors.initials: IC
authors.lastname: Mackie
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use*; D000284:Administration, Oral; D000367:Age Factors; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D010287:Parent-Child Relations; D011292:Premedication; D012737:Sex Factors; D016037:Single-Blind Method; D013312:Stress, Physiological / Q000517:prevention & control; D013315:Stress, Psychological / Q000517:prevention & control; D014081:Tooth Extraction
chemical_list: D018712:Analgesics, Non-Narcotic; D004338:Drug Combinations; D000082:Acetaminophen; D007052:Ibuprofen