Department of Anesthesia, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234-6200, USA.
Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam Houston, TX 78234-6200, USA.
Mil Med. 2024 Aug 30;189(9-10):e1955-e1959. doi: 10.1093/milmed/usae194.
Tonsillectomy ranks high among the most common pediatric surgical procedures in the United States. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are routinely prescribed to manage post-tonsillectomy pain, but may carry the risk of hemorrhage.
This retrospective, longitudinal, secondary-data analysis study compared the incidence of surgically managed post-tonsillectomy hemorrhage (sPTH) in pediatric patients prescribed ibuprofen at Brooke Army Medical Center (BAMC) after tonsillectomy compared to a similar cohort of pediatric patients at the Children's Hospital of Philadelphia (CHOP) not prescribed ibuprofen. Additional regression analysis examined predictors of sPTH at BAMC.
The odds of sPTH was lower in patients who were prescribed ibuprofen at BAMC, relative to patients who were not at CHOP (OR 0.57, 95% CI, 0.37, 0.87; P < 0.01). In a generalized linear model evaluating BAMC patient data, there was a lack of a relationship between reason for tonsillectomy (tonsillitis versus tonsillar obstruction), primary procedure (tonsillectomy-only versus tonsillectomy with adenoidectomy), and presence of a co-occurring procedure.
Post-tonsillectomy ibuprofen prescribing practices were not associated with an elevated risk of sPTH, relative to patients at CHOP not exposed to ibuprofen.
在美国，扁桃体切除术是最常见的儿科手术之一。非甾体抗炎药（NSAIDs），如布洛芬，通常被用于缓解扁桃体切除术后的疼痛，但可能存在出血风险。
本回顾性、纵向、二次数据分析研究比较了在布洛克陆军医疗中心（BAMC）接受扁桃体切除术后开具布洛芬的儿科患者与未开具布洛芬的费城儿童医院（CHOP）相似儿科患者中手术治疗的扁桃体切除术后出血（sPTH）的发生率。此外，回归分析还检查了 BAMC 患者 sPTH 的预测因素。
与未在 CHOP 开具布洛芬的患者相比，在 BAMC 开具布洛芬的患者发生 sPTH 的几率较低（OR 0.57，95%CI，0.37，0.87；P<0.01）。在评估 BAMC 患者数据的广义线性模型中，扁桃体切除术的原因（扁桃体炎与扁桃体阻塞）、主要手术（单纯扁桃体切除术与扁桃体切除术联合腺样体切除术）以及同时进行的手术之间不存在关系。
与未接受布洛芬治疗的 CHOP 患者相比，扁桃体切除术后开具布洛芬的做法与 sPTH 风险升高无关。
