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Postoperative analgesia with preoperative oral ibuprofen or acetaminophen in children undergoing myringotomy
R E Bennie1, L A Boehringer, S McMahon
1Department of Anesthesia, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202-5200, USA.
Insights
Preoperative acetaminophen or ibuprofen did not reduce pain after myringotomy and tube placement in children. This study found no analgesic benefit over placebo for these common pain relievers.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Otolaryngology
Background:
- Over 70% of children need pain relief after bilateral myringotomy and tube placement (BM&T).
- Effective pain management is crucial for pediatric surgical recovery.
Purpose of the Study:
- To compare the postoperative analgesic efficacy of preoperatively administered oral acetaminophen or ibuprofen versus placebo.
- To evaluate pain scores and need for rescue analgesia in children undergoing BM&T.
Main Methods:
- Double-blind, placebo-controlled study involving 43 children (age ≥ 6 months, ASA I/II) undergoing elective BM&T.
- Children were randomized to receive oral acetaminophen (15 mg/kg), ibuprofen (10 mg/kg), or placebo before surgery.
- Postoperative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) at multiple intervals.
Main Results:
- No significant differences in CHEOPS pain scores were observed between the acetaminophen, ibuprofen, and placebo groups at any assessment time.
- The number of children requiring rescue analgesia was similar across all three groups.
- Preoperative oral administration of acetaminophen or ibuprofen showed no added benefit over placebo for postoperative pain.
Conclusions:
- Preoperative oral acetaminophen or ibuprofen does not provide significant postoperative pain relief in children undergoing BM&T.
- Further research may be needed to explore alternative or multimodal pain management strategies for this pediatric population.
Abstract:
Previous studies have shown over 70% of children require analgesics following bilateral myringotomy and tube placement (BM&T). This double-blind, placebo-controlled study compared the postoperative analgesic effects of preoperatively administered oral acetaminophen or ibuprofen. Forty three ASA I or II children age six months or older scheduled for elective BM&T were randomized to receive acetaminophen (paracetamol) 15 mg.kg-1, ibuprofen 10 mg.kg-1, or placebo. Postoperative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) upon arrival to the PACU and at 5, 10, 15, 30, 45, and 60 min. CHEOP scores did not differ between the groups at any time. There was no difference in the number of children receiving rescue analgesia. This study showed no benefit of preoperatively administered oral ibuprofen 10 mg.kg-1 or acetaminophen 15 mg.kg-1 over placebo for the relief of postoperative pain in children undergoing BM&T.