Related Experiment Video
Updated: Aug 23, 2026
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Rofecoxib administration to paediatric patients undergoing adenotonsillectomy
P W Sheeran1, J B Rose, L M Fazi
1Departments of Anesthesiology and Pediatrics, University of Texas Southwestern Medical Center, USA. psheer@childmedodallas.fx.us
Insights
Rofecoxib did not increase bleeding in pediatric adenotonsillectomy patients. However, it did not reduce pain or morphine use compared to placebo in this study.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Rofecoxib, a selective COX-2 inhibitor, offers potential advantages over traditional NSAIDs due to its non-interference with platelet function and reduced bleeding risk.
- Adenotonsillectomy (T&A) is a common pediatric surgical procedure where pain management and bleeding are key concerns.
Purpose of the Study:
- To evaluate the safety and efficacy of rofecoxib in pediatric patients undergoing T&A.
- To assess rofecoxib's impact on bleeding, pain scores, and analgesic requirements post-T&A.
Main Methods:
- A double-blind, randomized, placebo-controlled study involving 45 pediatric patients (age >= 4 years) undergoing outpatient T&A.
- Patients received either oral rofecoxib (1 mg/kg) or placebo 30 minutes preoperatively.
- Pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Wong-Baker FACES Scales; morphine use and blood loss were also measured.
Main Results:
- No significant differences were observed between the rofecoxib and placebo groups regarding intraoperative blood loss.
- Pain scores, post-anesthetic care unit (PACU) morphine requirements, and discharge times showed no statistically significant variations between the two groups.
- Bleeding complications were not increased in the rofecoxib group.
Conclusions:
- Rofecoxib administration is safe for pediatric patients undergoing T&A, with no increased risk of bleeding.
- Rofecoxib did not demonstrate efficacy in reducing morphine consumption or improving pain scores in T&A patients who also received intraoperative morphine and acetaminophen.
- Further research may be needed to explore rofecoxib's role in pediatric pain management for T&A when used in conjunction with other analgesics.
Background:
Rofecoxib is a selective COX-2 inhibitor that does not interfere with platelet function and is associated with fewer bleeding complications than other nonsteroidal anti-inflammatory agents (NSAIDs). Our aims were to evaluate the safety and the efficacy of rofecoxib administration to paediatric patients undergoing adenotonsillectomy (T&A).
Methods:
We conducted a double-blind, randomized, placebo-controlled study of rofecoxib in 45 ASA 1-2 patients > or = 4 years of age undergoing outpatient T&A. All patients received midazolam 0.5 mg x kg(-1) (max 15 mg) p.o. and either rofecoxib 1 mg x .kg(-1) (max 25 mg) or placebo p.o. 30 min preoperatively. All patients had a standardized anaesthetic and were extubated awake in the operating room at the conclusion of surgery. The Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) scores were obtained on arrival in the postanaesthetic care unit (PACU). Morphine 25 microg x kg(-1) i.v. were administered up to six times for pain in the PACU. Wong-Baker FACES Scales were obtained at discharge from the PACU and the day surgery unit (DSU). Outcome measures included intraoperative estimated blood loss (EBL), pain scores, PACU morphine requirements and discharge times.
Results:
There were 23 patients in the rofecoxib group and 22 patients in the placebo group. There were no differences between the rofecoxib and placebo groups in terms of bleeding, pain scores, PACU morphine requirements, PACU times or DSU times.
Conclusion:
Rofecoxib administration to paediatric patients undergoing T&A did not result in increased bleeding. Rofecoxib, however, was not found to decrease morphine use or improve pain scores prior to hospital discharge in T&A patients who received intraoperative morphine and acetaminophen.
Related Concept Videos
01:29Drug Dosing: Infants and Children
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:26Tonsillitis II: Management