Comparison of intravenous and oral ketoprofen for postoperative pain after adenoidectomy in children

Abstract

One hundred children, aged 1-9 yr, undergoing adenoidectomy were randomized to receive ketoprofen 1 mg kg-1 either i.v. with an oral placebo (n = 40) or ketoprofen 1 mg kg-1 orally with an i.v. placebo (n = 40), or both oral and i.v. placebo (n = 20). The study design was prospective and double blind with parallel groups. The pain was assessed at rest and during swallowing using the Maunuksela pain scale (0 = no pain, 10 = worst possible pain) after surgery for 3 h. Fentanyl 0.5 microgram kg-1 i.v. was given for rescue analgesia. Children in the i.v. group needed significantly less doses (1, 1-3; median and 10th/90th percentiles) of rescue analgesic compared with the oral group (2, 1-3; P = 0.024). Of those who needed rescue analgesic, three out of 30 children in the i.v. group required three or more doses of fentanyl compared with 10 out of 28 children in the oral group. There were no differences between the groups with respect to pain scores, operation times, perioperative bleeding or frequency of adverse events.