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Ibuprofen in the treatment of postoperative pain in small children. A randomized double-blind-placebo controlled
H Kokki1, H Hendolin, E L Maunuksela
1Department of Anaesthesiology, Kuopio University Hospital, Finland.
Insights
Rectal ibuprofen effectively manages postoperative pain in children aged 1-4 years, reducing the need for morphine. This study found ibuprofen to be a safe and superior analgesic option for pediatric patients undergoing surgery.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Pain Management
Background:
- Postoperative pain in children is a significant clinical challenge.
- Effective preemptive analgesia is crucial for optimal recovery.
- Opioid-sparing strategies are desirable to minimize side effects.
Purpose of the Study:
- To evaluate the efficacy of rectal ibuprofen as a preemptive analgesic in children aged 1-4 years undergoing elective surgery.
- To compare pain relief and opioid requirements between ibuprofen and placebo groups.
- To assess the safety and side effect profile of rectal ibuprofen in this pediatric population.
Main Methods:
- Randomized, double-blind, placebo-controlled trial involving 81 children (1-4 years old).
- Patients received either rectal ibuprofen (40 mg.kg-1.d-1 divided into four doses) or placebo.
- Morphine was administered as additional pain relief when needed.
- Pain intensity, heart rate, and blood pressure were monitored.
Main Results:
- Ibuprofen provided superior pain relief during the first hour post-surgery.
- Significantly reduced the requirement for morphine in the ibuprofen group.
- Children receiving ibuprofen exhibited lower heart rate and arterial blood pressure, indicating better analgesia.
- Mild side effects were observed and were similar between groups.
Conclusions:
- Rectal ibuprofen is a safe and effective preemptive analgesic for postoperative pain in children aged 1-4 years.
- It significantly reduces the need for opioid analgesics, such as morphine.
- Ibuprofen offers a valuable non-opioid option for pediatric pain management after surgery.
Abstract:
The efficacy of ibuprofen as a pre-emptive analgesic for postoperative pain was investigated in 81 children in the age between one and four years subjected to elective surgery. The patients were randomized into two groups receiving rectally either ibuprofen 40 mg.kg-1.d-1, divided into four equal doses, or placebo in a double blind manner. Additional pain relief was provided by morphine. In the recovery room ibuprofen provided superior pain relief during the first hour and significantly reduced the need of morphine. Heart rate and arterial blood pressure were lower in children who received ibuprofen, probably reflecting better analgesia. The side effects were mild and similar in both groups. We conclude that rectal ibuprofen is a safe analgesic in children in the age between 1 and 4 years and reduces the need of opioids for postoperative pain relief.