Ibuprofen Potentiates an Analgesic Effect and Hastens a Recovery after Tonsillectomy in Children

Shin, Myoung Keun; ParK, Tae SiK; Kim, Tae Yop; Kim, In Kyu

Abstract

BACKGROUND: Various methods or regimens treating pain after a pediatric tonsillectomy were postulated. Ibuprofen, an NSAIDs, is Known to be useful due to its analgesic effects and safety in a pediatric tonsillectomy. Even though with rapid induction, emergence and nonirritating airway properties, sevoflurane may be associated with a agitation or delirium in a higher incidence compared with halothane in children. We performed this study to determine whether oral ibuprofen could have an influence on characteristics during emergence in addition to analgesic effects after use of sevoflurane/fentanyl in a pediatric tonsillectomy.
METHODS
Twenty nine pediatric patients scheduled for a tonsillectomy were assigned into two groups; an oral placebo (Group 1, n = 13) or ibuprofen 5 mg/Kg (Group 2, n = 16) was given 60 min before the operation. Rapid masK induction with sevoflurane and maintenance with sevoflurane, nitrous oxide and fentanyl were performed. After the tonsillectomy, patients were transferred to the PACU with prompt recovery. Postoperative pain and emergence were accessed by using VAS (1-5) and Aldrete scores at 5 min after the discharge from operating room. The incidences of agitation, vomiting and postoperative bleeding in addition to VAS scores and Aldrete scores were compared in both groups.
RESULTS
The VAS score in Group 2 (1.69 +/- 0.79) was lower than that of Group 1 (2.85 +/- 1.25) (P < 0.05). Aldrete score in Group 2 (8.69 +/- 0.86) is higher than that of Group 1 (9.88 +/- 0.34) (P < 0.05). There was no significant difference in incidence of agitation (38.5% in Group 1 and 18.8% in Group 2). There was no vomiting and bleeding in either groups.
CONCLUSIONS
Preoperative oral ibuprofen potentiates analgesic effects and hastens emergence time without any increase in the incidences of vomiting and bleeding. However ibuprofen does not decrease the incidence of agitation.