St Charles C S, Matt B H, Hamilton M M, Katz B P
Indiana University Medical Center, Indianapolis, USA.
Otolaryngol Head Neck Surg. 1997 Jul;117(1):76-82. doi: 10.1016/S0194-59989770211-0.
To compare the use of ibuprofen with the use of acetaminophen with codeine for posttonsillectomy management.
We 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.
Intervention, prospective, randomized control trial. Follow-up was 1 month.
University referral center; institutional pediatric practice, ambulatory.
110 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.
Patients received either acetaminophen with codeine (group 1) or ibuprofen (group 2) for postoperative pain control.
The 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.
The 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.
Ibuprofen is at least as effective as acetaminophen with codeine for postoperative pain control in children after tonsillectomy.
比较布洛芬与对乙酰氨基酚加可待因在扁桃体切除术后管理中的应用。
我们对扁桃体切除患者的传统疼痛管理方法不满意。我们希望找到一种新方法来提高患者舒适度，并避免使用如可待因这类有滥用风险的处方药。
干预性、前瞻性、随机对照试验。随访1个月。
大学转诊中心；机构儿科门诊。
110名接受扁桃体切除术的儿童，无论是否进行其他手术。连续的患者被邀请参与。入组患者被随机分配到两个组之一，并按初始分组进行分析。尽管第2组有12名患者使用了可待因，其中5名还使用了对乙酰氨基酚，而第1组有2名患者接受了布洛芬治疗，但没有患者因不良反应退出。
患者术后疼痛控制分别使用对乙酰氨基酚加可待因（第1组）或布洛芬（第2组）。
在研究开始前确定的主要观察指标包括：（1）术后出血情况；（2）疼痛程度；（3）药物缓解疼痛的效果；（4）恶心情况；（5）呕吐情况；（6）再次入院情况；（7）平均体温；（8）术后最高体温。
唯一具有统计学意义的差异是使用布洛芬的患者恶心情况较少（p = 0.0049）。值得注意的是，术后出血、疼痛或体温控制方面没有差异。
在扁桃体切除术后儿童的疼痛控制方面，布洛芬至少与对乙酰氨基酚加可待因一样有效。
