Related Experiment Video
Updated: Aug 16, 2025
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Effect of ibuprofen on severity of surgically-managed pediatric post-tonsillectomy hemorrhage
Emma De Ravin1, Grace L Banik2, Adva Buzi3
1Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Insights
Ibuprofen use after tonsillectomy did not increase post-tonsillectomy hemorrhage (PTH) severity. This study found no significant differences in blood loss or transfusion needs between patients who received ibuprofen and those who did not.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Pharmacology
Background:
- Post-tonsillectomy hemorrhage (PTH) is a common complication.
- The safety of ibuprofen for pain management following tonsillectomy is debated.
- Previous studies have yielded conflicting results regarding ibuprofen's effect on PTH severity.
Purpose of the Study:
- To investigate the association between postoperative ibuprofen use and the severity of post-tonsillectomy hemorrhage (PTH) in pediatric patients.
- To compare PTH severity markers in patients who received ibuprofen versus those who did not.
Main Methods:
- Retrospective cohort study of pediatric patients undergoing operative control for PTH (2015-2019).
- PTH severity assessed by hemoglobin/hematocrit changes, estimated blood loss, hemorrhage flow rate, and transfusion requirements.
- Comparison of severity markers between ibuprofen and non-ibuprofen cohorts.
Main Results:
- 168 pediatric patients included; 38.7% received ibuprofen postoperatively.
- No significant differences in mean hemoglobin or hematocrit changes between groups.
- Similar rates of transfusion and high-flow (arterial) blood loss in both ibuprofen and non-ibuprofen groups.
Conclusions:
- Postoperative ibuprofen administration does not appear to significantly increase PTH severity.
- Study utilized novel markers for assessing PTH severity.
- Further prospective research is recommended to confirm these findings.
Objectives:
The association between ibuprofen use and severity of post-tonsillectomy hemorrhage (PTH) remains unclear. We aimed to compare PTH severity in patients who did or did not receive ibuprofen.
Methods:
A retrospective cohort study of pediatric patients requiring operative control of PTH at a tertiary children's hospital between 2015 and 2019 was performed. PTH severity was assessed using pre-tonsillectomy and post-hemorrhage hemoglobin and hematocrit values, estimated intraoperative blood loss, estimated hemorrhage flow rate, and need for transfusion. Differences in hemorrhage severity markers between the two cohorts were compared.
Results:
A total of 168 consecutive patients were included in this study. The mean age was 8.8 years, and 55.4% of patients were male. Sixty-five patients (38.7%) received ibuprofen postoperatively. There was no statistically significant difference in the mean change in hemoglobin (1.1 vs. 1.1, P = 0.85) or hematocrit (3.1 vs. 3.2, P = 0.97) between patients who received ibuprofen compared to those who did not. Similarly, there were no significant differences in need for transfusion (3.1% vs. 3.9%, P = 1.00) or occurrence of high-flow (arterial) blood loss (33.8% vs. 40.8%, P = 0.42) between the two groups.
Conclusion:
Postoperative ibuprofen use does not appear to significantly increase PTH severity, as measured by change in hemoglobin and hematocrit values, need for transfusion, or presence of high-flow blood loss. This study introduces previously unexplored markers to assess PTH severity and supports further prospective studies to determine the effect of ibuprofen on PTH severity.
Related Concept Videos
01:26Tonsillitis II: Management
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
01:22Aneurysm IV: Nursing Management
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...