• Jolene D Bean-Lijewski, Shane H Kruitbosch, Lewis Hutchinson, and Barry Browne.
• Department of Anesthesiology, Scott & White Memorial Hospital, Temple, TX 76508, USA. jbean.lijewski@swmail.sw.org
• Otolaryngol Head Neck Surg. 2007 Oct 1;137(4):545-51.

ObjectiveThe search for an effective post-tonsillectomy analgesic has been disappointing. This study tests the hypothesis that rofecoxib improves pain scores in children for 72 hours post-tonsillectomy when compared to hydrocodone with acetaminophen elixir.Study DesignProspective, randomized, double-blind, active comparison of postoperatively administered rofecoxib or hydrocodone with acetaminophen in 60 healthy children scheduled for elective tonsillectomy.Subjects And MethodsSixty ASA I and II children scheduled for elective tonsillectomy were enrolled to receive either rofecoxib or hydrocodone with acetaminophen, commencing at discharge from day surgery. Active and passive pain scores and side effects were assessed for 3 days.Results And ConclusionRofecoxib significantly reduced active pain scores at all time intervals after 6 hours following surgery when compared to hydrocodone with acetaminophen without detectable differences in adverse effects. This difference was not apparent in passive pain scores. A review of analgesic strategies is presented. Study results and review of the literature support the development of pediatric formulations of NSAIDs with greater COX-2 selectivity to improve postsurgical pain relief for children.

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