Abstract | BACKGROUND: METHODS: This prospective randomized clinical trial recruited children who had sleep disordered breathing who were scheduled for tonsillectomy +/- adenoid removal. Parents were provided with a pulse oximeter to measure oxygen saturation and apnea events the night before and the night after surgery. Children were randomized to receive acetaminophen with either 0.2-0.5 mg/kg oral morphine or 10 mg/kg of oral ibuprofen. The Objective Pain Scale and Faces Scale were used to assess effectiveness on postoperative day 1 and day 5. The primary endpoint was changes in respiratory parameters during sleep. RESULTS: A total of 91 children aged 1 to 10 years were randomized. On the first postoperative night, with respect to oxygen desaturations, 86% of children did not show improvement in the morphine group, whereas 68% of ibuprofen patients did show improvement (14% vs 68%; P < .01). The number of desaturation events increased substantially in the morphine group, with an average increase of 11.17 ± 15.02 desaturation events per hour (P < .01). There were no differences seen in analgesic effectiveness, tonsillar bleeding, or adverse drug reactions. CONCLUSIONS:
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Authors | Lauren E Kelly, Doron D Sommer, Jayant Ramakrishna, Stephanie Hoffbauer, Sadaf Arbab-Tafti, Diane Reid, Jonathan Maclean, Gideon Koren |
Journal | Pediatrics
(Pediatrics)
Vol. 135
Issue 2
Pg. 307-13
(Feb 2015)
ISSN: 1098-4275 [Electronic] United States |
PMID | 25624387
(Publication Type: Consensus Development Conference, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 by the American Academy of Pediatrics. |
Chemical References |
- Acetaminophen
- Morphine
- Oxygen
- Ibuprofen
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Topics |
- Acetaminophen
(therapeutic use)
- Adenoidectomy
- Administration, Oral
- Child
- Child, Preschool
- Dose-Response Relationship, Drug
- Drug Therapy, Combination
- Female
- Humans
- Ibuprofen
(adverse effects, therapeutic use)
- Infant
- Male
- Morphine
(adverse effects, therapeutic use)
- Oxygen
(blood)
- Pain Measurement
(drug effects)
- Pain, Postoperative
(blood, drug therapy)
- Prospective Studies
- Sleep Apnea, Obstructive
(surgery)
- Tonsillectomy
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