Painkillers safe for kids after tonsil surgery

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Children recovering from having their tonsils and adenoids removed can be given painkillers like ibuprofen without increasing the risk of postop bleeding, according to a new study.

“After surgery, such as tonsillectomy, almost all children have considerable pain for longer than 7 days ... and the need for effective pain management is obvious,” Dr. Anita Jeyakumar from Washington University School of Medicine, St. Louis, and colleagues note in the Archives of Otolaryngology--Head and Neck Surgery.

However, there is conflicting information about whether painkillers called nonsteroidal antiinflammatory drugs or NSAIDs (ibuprofen is one of several in the class) increase postoperative bleeding, and “many otolaryngologists are very hesitant about using NSAIDs.”

Against this backdrop, Jeyakumar’s group evaluated the rate of bleeding associated with NSAIDs in 1160 children undergoing adenotonsillectomy or tonsillectomy.

Of the total group, 487 were given weight-appropriate doses of ibuprofen before and after surgery, whereas 673 were not.

There was no immediate postop bleeding (within 24 hours of surgery) in either group and there was no statistical difference in bleeding rates between the two groups during the 1-month follow up period, the team found.

“This was my expected result,” Jeyakumar noted in comments to Reuters Health.

Ibuprofen “should be used in the control of postoperative pain if it is indicated in the patient,” the investigators conclude.

“Our patients would benefit from improved pain control following any surgical procedure,” Jeyakumar added.

SOURCE: Archives of Otolaryngology--Head and Neck Surgery, January 2008.

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