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Association of ibuprofen use with post-tonsillectomy bleeding in older children

Robert T Swanson1, Jane R Schubart2, Michele M Carr3

  • 1College of Medicine, The Pennsylvania State University, College of Medicine, Hershey, PA, United States.

American Journal of Otolaryngology
|May 31, 2018
PubMed

Insights

Ibuprofen use after tonsillectomy in children is linked to increased bleeding, especially in older age groups. Alternative pain relief options should be explored for safer post-operative care.

Area of Science:

  • Pediatric Otolaryngology
  • Pain Management
  • Surgical Outcomes

Background:

  • Tonsillectomy is a common pediatric surgical procedure.
  • Post-tonsillectomy pain management often involves non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
  • The safety and efficacy of ibuprofen for post-tonsillectomy pain require careful consideration.

Purpose of the Study:

  • To evaluate the impact of ibuprofen use on post-tonsillectomy outcomes in children.
  • To compare bleed rates, emergency room visits, and nurse calls between children discharged with ibuprofen and those without.

Main Methods:

  • Retrospective review of 773 children undergoing tonsillectomy ± adenoidectomy (2012-2016).
  • Comparison of outcomes between patients discharged with ibuprofen (ID) and those not (NID).
  • Analysis of bleed rates, ER visits, and nurse phone calls as primary outcomes.

Main Results:

  • No significant difference in overall bleed rates between ID (8.7%) and NID (5.9%) groups (P=0.168).
  • Older children (9-18 years) showed higher bleeding rates, particularly in the ID group (16.7% vs 7.5%, P=0.039).
  • Logistic regression indicated age as a factor for bleeding and ibuprofen for increased ER visits.

Conclusions:

  • Ibuprofen is associated with a significantly increased risk of post-tonsillectomy bleeding in older children.
  • Further research is warranted to explore alternative analgesics for post-tonsillectomy pain management.
  • Consideration of alternative pain relief strategies may improve patient safety.
Abstract

Keywords:
HemorrhageIbuprofenPediatricSurgeryTonsillectomy

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