title: The analgesic efficacy of preoperative oral Ibuprofen and acetaminophen in children undergoing adenotonsillectomy: a randomized clinical trial.
abstract: BACKGROUND
  Adenotonsillectomy is one of the most common surgical procedures in children. Several complications and morbidities are common after nasal surgeries and the most common is pain. Several techniques have been employed to reduce the severity of postoperative pain. One of the preoperative techniques is pre-emptive analgesia through preventive central hypersensitization. This technique is performed by applying analgesic methods before the onset of nociceptive stimuli, consequently decreasing postoperative analgesics requirements.
  
  
  OBJECTIVE
  Preoperative oral drug administration for pain analgesia is performed in several methods. The aim of this study was to compare the analgesic effects of preoperatively administration of oral acetaminophen and ibuprofen.
  
  
  METHODS
  In a double-blinded, randomized placebo-controlled study, sixty 4-12 years old ASA I or II children scheduled for elective adenotonsillectomy, were assigned to receive either acetaminophen 15 mg/kg, ibuprofen 10 mg/kg or placebo 30 minutes before the operation. Postoperative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), upon arrival to the post anesthetic care unit (PACU) and ward. Findings were analyzed by SPSS version 17 using variance analysis and Tukey's test.
  
  
  RESULTS
  The average pain intensities were significantly lower in acetaminophen group based on the CHEOPS in both PACU and ward compared to ibuprofen or placebo groups; but there was no difference in pain intensity between the ibuprofen and placebo groups. Pain intensity in PACU in Acetaminophen group was 7.05 ± 0.64 vs. 8.38 ± 1.20 in placebo group and 8.14 ± 0.85 in ibuprofen group, pain intensity in ward in the acetaminophen group was 6.0.87 ± 0.85in the acetaminophen group, vs. 8.04 ± 1.02 in placebo group, and 7.78 ± 0.78 in ibuprofen group.
  
  
  CONCLUSIONS
  This study showed that administration of oral acetaminophen 30 minutes preoperatively, resulted in significantly lower pain intensity in children undergoing adenotonsillectomy in PACU and ward, compared to ibuprofen and placebo.
authors.affiliation: Department of Anesthesiology and Children and Adolescent Health Research Center, Ali-Ebne Abitaleeb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Maziar
authors.initials: M
authors.lastname: Mahgoobifard
authors.affiliation: Heart Value Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Mirmesdagh
authors.affiliation: Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farsad
authors.initials: F
authors.lastname: Imani
authors.affiliation: Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Atabak
authors.initials: A
authors.lastname: Najafi
authors.affiliation: Research Development Center of Arash Woman's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Nataj-Majd
keywords: Acetaminophen; Ibuprofen; Pain, Postoperative