Comparison of intravenous ibuprofen and paracetamol for peri-operative analgesia in paediatric day care tonsillectomy: research article

Abstract

Objective: To determine the effectiveness of intravenous ibuprofen and acetaminophen as perioperative analgesics in paediatric patients undergoing day-care tonsillectomy with general anaesthesia.

Method: The quasi-experimental study was conducted at the Anaesthesia Department of Pak Emirates Military Hospital, Rawalpindi, Pakistan, from July 2021 to June 2022, and comprised paediatric patients aged 5-12 years undergoing day-care tonsillectomy with general anaesthesia. The subjects were divided into two equal groups. Patients in Group I received intravenous ibuprofen 7mg/kg and patients in Group P received intravenous paracetamol 10mg/kg immediately after induction of anaesthesia. All patients received standard general anaesthesia with endotracheal intubation. The primary outcome measured was revised faces pain score immediately after recovery and at the time of discharge 6 hours later. Adverse events were also noted. Data was analysed using SPSS 26.

Results: Of the 100 patients, there were 50(50%) in Group I; 21(42%) boys and 29(58%) girls with mean age 7.82±1.903 years. The remaining 50(50%) subjects were in Group P; 25(50%) boys and 25(50%) girls with mean age 7.68±1.812 years. At baseline, 44(88%) patients in Group I and 42(84%) in Group P reported no pain, while 6(12%) and 8(16%) patients in the two groups, respectively, reported pain (p=0.56). At discharge, 35(70%) patients in Group I and 18(36%) in Group P reported no pain (p<0.001). Adverse events were not significantly different between the groups (p>0.05).

Conclusion: Intravenous ibuprofen was found to be a superior pain-killer than intravenous paracetamol for peri-operative care of paediatric patients in day-care tonsillectomy.

Key Words: Acetaminophen, Analgesia, Ibuprofen, Paracetamol, Revised faces pain score, FPS-R.