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Acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy
1Division of Otolaryngology--Head and Neck Surgery, Stanford University Medical Center, California, USA.
Insights
Acetaminophen alone provided similar pain relief to acetaminophen with codeine for children after tonsillectomy. Children receiving acetaminophen alone consumed more food post-surgery.
Area of Science:
- Pediatric surgery
- Pain management
- Pharmacology
Background:
- Tonsillectomy and adenoidectomy are common pediatric procedures.
- Effective postoperative pain management is crucial for recovery.
- Opioid-sparing analgesia is desirable in pediatric populations.
Purpose of the Study:
- To compare the efficacy of acetaminophen versus acetaminophen with codeine for pain control after pediatric tonsillectomy and adenoidectomy.
- To evaluate postoperative pain levels, medication use, side effects, and oral intake.
Main Methods:
- Prospective, randomized, double-blind study involving 51 children aged 3-12 years.
- Children received either acetaminophen or acetaminophen with codeine for pain.
- Pain was assessed using the Wong-Baker FACES scale over 10 postoperative days.
Main Results:
- No significant difference in pain levels between the two groups.
- Acetaminophen with codeine group showed a trend towards more nausea, emesis, and constipation.
- Children receiving acetaminophen alone consumed a significantly higher percentage of a normal diet post-surgery.
Conclusions:
- Acetaminophen and acetaminophen with codeine offer comparable pain relief after pediatric tonsillectomy and adenoidectomy.
- Acetaminophen alone may promote better oral intake in the early postoperative period.
- This suggests acetaminophen monotherapy as a viable option for pain management in this population.
Objective:
To compare the effectiveness of acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy and adenoidectomy.
Study Design:
Prospective, randomized, double-blind study.
Methods:
Fifty-one children ages 3 to 12 years scheduled for outpatient tonsillectomy and adenoidectomy were studied. Patients were randomly assigned to receive acetaminophen or acetaminophen with codeine in unlabeled bottles for postoperative pain control. The Wong-Baker FACES pain rating scale was used to help children quantify their level of pain after surgery. The level of pain, quantity of pain medication required, presence of side effects, and the percentage of a normal diet consumed was recorded for 10 postoperative days.
Results:
There was no difference (P > .05, all time points) in the level of postoperative pain reported by the parents and children in the two groups. The acetaminophen with codeine group tended to have increased problems with nausea, emesis, and constipation, but these differences did not reach statistical significance. Children in the acetaminophen group consumed a significantly higher percentage of a normal diet on the first 6 postoperative days (P < .05, all time points).
Conclusion:
There was no difference in the level of pain control provided by acetaminophen and acetaminophen with codeine as measured by the Wong-Baker FACES pain rating scale. Postoperative oral intake was significantly higher in children treated with acetaminophen alone.