Comparative study of acetaminophen-morphine versus rofecoxib-morphine for post-tonsillectomy pain control

Area of Science:

• Pediatric Surgery
• Pain Management
• Pharmacology

Background:

• Post-tonsillectomy pain often persists despite morphine use.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) offer relief but carry bleeding risks.
• Selective cyclooxygenase type 2 (COX-2) inhibitors like rofecoxib may mitigate bleeding concerns.

Purpose of the Study:

• To compare the efficacy and safety of rofecoxib-morphine versus acetaminophen-morphine for post-tonsillectomy pain control in children.
• To evaluate pain scores, medication use, side effects, and recovery speed.

Main Methods:

• Prospective comparative study involving 80 children aged 5-17 undergoing tonsillectomy.
• Participants were randomized into two groups: acetaminophen-morphine (n=40) and rofecoxib-morphine (n=40).
• Data collected via telephone on days 1, 3, and 7 post-surgery included pain scores, medication, side effects, and general health status.

Main Results:

• The rofecoxib-morphine group reported significantly lower pain scores on days 0 (home arrival and average), 1, 3, and 7 compared to the acetaminophen-morphine group.
• Children receiving rofecoxib demonstrated quicker return to drinking, eating, and regular activities.
• No adverse side effects were reported in the rofecoxib group.

Conclusions:

• Rofecoxib, a COX-2 inhibitor, effectively reduces post-tonsillectomy pain in pediatric patients.
• The combination of rofecoxib and morphine is a safe and beneficial option for managing pain and accelerating recovery after tonsillectomy.