Background:Adenotonsillectomy is one of the most common surgical procedures in children. Several complications and morbidities are common after nasal surgeries and the most common is pain. Several techniques have been employed to reduce the severity of postoperative pain. One of the preoperative techniques is pre-emptive analgesia through preventive central hypersensitization. This technique is performed by applying analgesic methods before the onset of nociceptive stimuli, consequently decreasing postoperative analgesics requirements.Objectives:Preoperative oral drug administration for pain analgesia is performed in several methods. The aim of this study was to compare the analgesic effects of preoperatively administration of oral acetaminophen and ibuprofen.Patients and Methods:In a double-blinded, randomized placebo-controlled study, sixty 4-12 years old ASA I or II children scheduled for elective adenotonsillectomy, were assigned to receive either acetaminophen 15 mg/kg, ibuprofen 10 mg/kg or placebo 30 minutes before the operation. Postoperative pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), upon arrival to the post anesthetic care unit (PACU) and ward. Findings were analyzed by SPSS version 17 using variance analysis and Tukey’s test.Results:The average pain intensities were significantly lower in acetaminophen group based on the CHEOPS in both PACU and ward compared to ibuprofen or placebo groups; but there was no difference in pain intensity between the ibuprofen and placebo groups. Pain intensity in PACU in Acetaminophen group was 7.05 ± 0.64 vs. 8.38 ± 1.20 in placebo group and 8.14 ± 0.85 in ibuprofen group, pain intensity in ward in the acetaminophen group was 6.0.87 ± 0.85in the acetaminophen group, vs. 8.04 ± 1.02 in placebo group, and 7.78 ± 0.78 in ibuprofen group.Conclusions:This study showed that administration of oral acetaminophen 30 minutes preoperatively, resulted in significantly lower pain intensity in children undergoing adenotonsillectomy in PACU and ward, compared to ibuprofen and placebo.

Background: Shivering is a frequent phenomenon in postoperative period. Post spinal shivering causes a major distress for patients and may induce some complications. Investigations to control shivering could not mange it completely.Objectives: The aim of this randomized single-blind study was to investigate how much the high dose (50 µg) of intrathecally administered fentanyl would influence the incidence and severity of shivering in patients undergoing abdominal hysterectomy. Methods:In this prospective clinical trial, seventy healthy patients scheduled for abdominal hysterectomy under spinal anesthesia using 75 mg of hyperbaric 5% lidocaine were randomly allocated to receive an additional 50 µg (1 mL) of fentanyl intrathecally (group F) or normal saline 1 mL (groups).Then the level of shivering was measured with crossly and mahajon scale and analyzed with chi-square test using SPSS version 17 software. Results:The incidence of shivering up to two hours after spinal anesthesia was 13 from 35 patients (37.2 %) in group F, and 27 from 35 patients (77.2%) in group S. The difference was statistically significant (P < 0.01). The shivering score was significantly lower in group F. There was no difference in the incidence of pharmacologic side effects. Conclusions:Addition of 50 µg fentanyl to 75 mg of hyperbaric 5% lidocaine intrathecally can reduce the incidence and severity of shivering in patients who receive abdominal hysterectomy without increasing other side effects.