Double-blind, placebo-controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children

Pickering, Anthony E.; Bridge, Hilary S.; Nolan, Judith A.; Stoddart, Peter

doi:10.1093/bja/88.1.72

Cited by 176 publications

(153 citation statements)

References 27 publications

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“…14 Results of all three studies showed the combination treatment to be superior to acetaminophen alone, although studies comparing the combination treatment with ibuprofen alone showed conflicting results. 14,16 These conclusions are inconsistent with our data showing no difference between the three treatments with regard to the primary outcome measure. Our secondary findings are more aligned with this previous work.…”

Section: Discussioncontrasting

confidence: 79%

“…8 Data pertaining to children are limited to three studies using a variety of pain assessment techniques and outcome measures in tonsillectomy and dental pain models. [14][15][16] All of these studies assessed the combination of acetaminophen and ibuprofen using a single-dose design, and one used a rectal route of administration. 14 Results of all three studies showed the combination treatment to be superior to acetaminophen alone, although studies comparing the combination treatment with ibuprofen alone showed conflicting results.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Randomized comparison between the combination of acetaminophen and ibuprofen and each constituent alone for analgesia following tonsillectomy in children

Merry

Edwards

Ahmad

et al. 2013

Can J Anesth/J Can Anesth

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Randomized comparison between the combination of acetaminophen and ibuprofen and each constituent alone for analgesia following tonsillectomy in children

Merry

Edwards

Ahmad

et al. 2013

Can J Anesth/J Can Anesth

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“…Combining nsNSAIDs and paracetamol has been shown to improve analgesia and/or decrease the need for additional analgesia after adenoidectomy (Viitanen et al, 2003 Level II), tonsillectomy (Pickering et al, 2002 Level II), inguinal surgery (Riad & Moussa, 2007 Level II), multiple dental extractions (Gazal & Mackie, 2007 Level II), and orthopaedic surgery (Hiller et al, 2006 Level II). As a component of multimodal analgesia, nsNSAIDs decrease opioid consumption (Antila et al, 2006 Level II; Rugyte & Kokki, 2007 Level II).…”

Section: Non-selective Non-steroidal Anti-inflammatory Drugsmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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“…In a recent study in children undergoing appendicectomy, paracetamol with diclofenac did not provide additional benefit compared with either drug alone. In contrast, the addition of ibuprofen to paracetamol reduced the need for early analgesia from 72 to 38% after tonsillectomy in children 3-15 years [10]. No previous studies have addressed postoperative pain relief after inguinal hernia surgery using pre-operative administration of paracetamol and diclofenac.…”

mentioning

confidence: 99%

Pre‐operative analgesia with rectal diclofenac and/or paracetamol in children undergoing inguinal hernia repair

Riad

Moussa

2007

Anaesthesia

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SummaryBoth rectal diclofenac and paracetamol are commonly used to treat acute postoperative pain in children but combining them to improve the quality of analgesia is controversial. This study aimed to detect whether the pre-operative combined administration of rectal diclofenac and paracetamol is superior to either drug alone. One hundred and eight patients were randomly assigned to receive either rectal diclofenac 1 mg.kg )1 or paracetamol 40 mg.kg )1 or their combination 1 h prior to surgery. In the first 24 h postoperatively, pain was assessed using the Wong and Baker Pain Scale. If the patients experienced a pain score of 2 or more, morphine was given. The total dose of morphine and number of doses required were recorded. Children who received the rectal diclofenac-paracetamol combination experienced a lower pain scale and a decreased need for morphine compared with children receiving each drug alone.

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Double-blind, placebo-controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children

Abstract: This study provides evidence to support the combination of ibuprofen (but not rofecoxib) with paracetamol for perioperative analgesia in children.

Cited by 176 publications

References 27 publications

Randomized comparison between the combination of acetaminophen and ibuprofen and each constituent alone for analgesia following tonsillectomy in children

Randomized comparison between the combination of acetaminophen and ibuprofen and each constituent alone for analgesia following tonsillectomy in children

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Pre‐operative analgesia with rectal diclofenac and/or paracetamol in children undergoing inguinal hernia repair

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