• Treatment: Is ibuprofen a safer and more efficacious postsurgical analgesic agent rather

than morphine for post-tonsillectomy?

PATIENT/ INTERVENTION COMPARISON OUTCOME

FOCUS
POPULATION
This prospective Acetaminophen with Acetaminophen with Ibuprofen in
randomized clinical 0.2-0.5 mg/kg oral 0.2-0.5 mg/kg oral combination with
trial recruited children ibuprofen. morphine. acetaminophen
who had sleep provides safe and
disordered effective
breathing who were analgesia in children
scheduled for undergoing
tonsillectomy +/2 tonsillectomy. Post-
adenoid removal. A tonsillectomy
total of 91 children morphine use should
were consented to be
participate in the limited, as it may be
study. Children were unsafe in certain
randomized to receive children.
acetaminophen with
either 0.2–0.5
mg/kg oral morphine
or 10 mg/kg of oral
ibuprofen.

Critical Review with Summary of the Literature

Sleep disordered breathing (SDB) is characterized by a disruption in ventilation and

breathing patterns during sleep. In children, SDB is often caused by hypertrophy of the tonsils
and/or adenoids and is commonly managed by tonsillectomy. Until recently, codeine was
commonly prescribed for postoperative pain management in many North American centers.
The Federal Drug Administration issued a Drug Safety communication advising practitioners
that codeine use in certain children could lead to rare but life-threatening respiratory failure
and death.
 In conclusion, this study demonstrates that 68% of the children who received ibuprofen after
the surgery showed improvement rather than those 86% children who did not during the first
postoperative night. The study revealed that the standard dosage range of morphine analgesia
increases the risk of oxygen desaturation comparing to ibuprofen.
REFFERENCES
Kelly, L. et al, (2015), Morphine or Ibuprofen for post-tonsillectomy analgesia: A randomized
trial, retrieved from https://pediatrics.aappublications.org/content/pediatrics/135/2/307.full.pdf