title: Analgesia following adenotonsillar surgery in children: is Oramorph required in addition to paracetamol and ibuprofen?
abstract: BACKGROUND
  Recent advice against codeine use in children prompted our unit to prescribe Oramorph as required, in addition to regular paracetamol and ibuprofen, as post-(adeno)tonsillectomy analgesia. This study investigated whether Oramorph was in fact required.
  
  
  METHODS
  Following (adeno)tonsillectomy, parents were telephoned and asked whether they used Oramorph.
  
  
  RESULTS
  Of 56 children studied, 41 (73.2%) were given Oramorph. In the 15 (26.8%) that were not, this was because parents felt it was not required in 14 children, and in 1 case, it was due to worries about side effects. Overall, 14 carers (25.0%) expressed concerns about Oramorph use, mostly over possible side effects.
  
  
  CONCLUSIONS
  When regular paracetamol and ibuprofen are used post-(adeno)tonsillectomy, nearly three quarters of children require Oramorph as well. Prescribing Oramorph as required, in addition to regular paracetamol and ibuprofen, is appropriate following adenotonsillar surgery.
authors.affiliation: Ear, nose and throat department, Queen's medical centre, Nottingham university hospitals NHS Trust, Derby road, NG7 2UH Nottingham, United Kingdom. Electronic address: richardwcgan@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Wei Chern Gan
authors.affiliation: Ear, nose and throat department, Sheffield Children's hospital, Sheffield Children's NHS Foundation Trust, Western Bank, S10 2TH Sheffield, United Kingdom.
authors.forename: T
authors.initials: T
authors.lastname: Kamani
authors.affiliation: Ear, nose and throat department, Queen's medical centre, Nottingham university hospitals NHS Trust, Derby road, NG7 2UH Nottingham, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Daniel
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000233:Adenoidectomy; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007223:Infant; D009020:Morphine / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D010290:Parents; D012189:Retrospective Studies; D014068:Tonsillectomy
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D009020:Morphine; D007052:Ibuprofen
keywords: Adenoidectomy; Analgesia; Child; Morphine; Otolaryngology; Pain; Tonsillectomy