• C S St Charles, B H Matt, M M Hamilton, and B P Katz.
• Indiana University Medical Center, Indianapolis, USA.
• Otolaryngol Head Neck Surg. 1997 Jul 1;117(1):76-82.

ObjectiveTo compare the use of ibuprofen with the use of acetaminophen with codeine for posttonsillectomy management.BackgroundWe were not satisfied with our traditional pain-management practice for tonsillectomy patients. We hoped to find a new approach for improved patient comfort and avoid scheduled, abusable drugs such as codeine.DesignIntervention, prospective, randomized control trial. Follow-up was 1 month.SettingUniversity referral center; institutional pediatric practice, ambulatory.Patients110 children undergoing tonsillectomy with or without other procedures. Consecutive patients were offered participation. Enrollees were randomly assigned to one of two classes and analyzed with the initial assignment. No patients withdrew for adverse effects, although 12 in group 2 used codeine and 5 of those used acetaminophen, whereas 2 in group 1 received ibuprofen.InterventionsPatients received either acetaminophen with codeine (group 1) or ibuprofen (group 2) for postoperative pain control.Main Outcome MeasuresThe main outcomes, determined before initiation of the study, were assessment of (1) postoperative bleeding, (2) pain, (3) efficacy of relief of pain by drug, (4) nausea, (5) emesis, (6) readmission to hospital, (7) average temperature, and (8) highest temperature after surgery.ResultsThe only statistically significant difference is less nausea in patients receiving ibuprofen (p = 0.0049). Of note, no difference existed in postoperative bleeding, pain, or temperature control.ConclusionsIbuprofen is at least as effective as acetaminophen with codeine for postoperative pain control in children after tonsillectomy.

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