MULTIDISCIPLINARY PAIN ABSTRACTS: 7 . Anesthesia (3)

Abstract

The authors of this study investigated if combining rectal acetaminophen with ibuprofen would provide better postoperative analgesia compared with either drug alone after adenoidectomy in children. One hundred and sixty children, aged 1–6 years, undergoing day‐case adenoidectomy, were randomized to receive either acetaminophen 40 mg/kg, ibuprofen 15 mg/kg, their combination, or placebo rectally immediately after anesthetic induction. A standard anesthetic method was used and all children received alfentanil 10 μg/kg IV during induction. Meperidine 5–10 mg IV was used for rescue analgesia for a pain score (Objective Pain Scale) over 3. Recovery times, sedation scores, and the need for rescue analgesia and adverse events during the first 24 hours after anesthesia were recorded. Rescue analgesic at home was ibuprofen 10 mg/kg. Total meperidine requirements were significantly less in the groups receiving acetaminophen, ibuprofen, or their combination compared with the group receiving placebo indicating an opioid‐sparing effect of 19% to 28%. Children given acetaminophen were more sedated than children given ibuprofen. Discharge criteria were fulfilled earlier in the ibuprofen group than in all the other groups. At home, less children needed rescue analgesia in the combination group compared with the other groups. Conclude that prophylactically administered rectal acetaminophen combined with ibuprofen does not improve analgesia after adenoidectomy in the immediate postoperative period compared with either drug alone but does decrease the need for analgesia at home. Ibuprofen results in lesser sedation and faster discharge than when acetaminophen is used.