For the study, Dr. Standring and study co-author Kathleen Yaremchuk, M.D., enrolled 91 patients in the study of varying age from June 2011 to August 2013, all of whom underwent the same surgical procedure to remove their tonsils. Patients ranged in age from 3 to 38.
During the pre-operative evaluation, patients were given a packet, randomly assigning them to one of three pain regimens – ibuprofen, acetaminophen with hydrocodone, or acetaminophen with codeine. The pain regimen was appropriately dosed by the patient’s weight.
The packet also included a post-operative evaluation form, wherein patients and/or their families were asked to rate their pain twice daily on a scale of 1 to 10, using a validated pediatric pain scale. Pain was recorded for the 10 days after surgery.
Patients were also asked to record the amount of pain medication given, as well as the amount of liquid or food consumed. Finally, patients were asked to list the day that they returned to work or school, and any complications with the procedure or the medication.
Twenty-five patients completed the post-operative package. Twelve took ibuprofen, eight took acetaminophen with hydrocodone, and five took acetaminophen with codeine. When the FDA issued a warning on the use of codeine in children, the researchers stopped enrolling children in that arm of the study.
When comparing all three patient groups, the researchers found no significant difference in pain control. All three pain relievers caused a significant decline in pain scores over time and had no significant difference in the time it took for patients to return to work or school, as well as their regular diet and activities.
The researchers noted, however, that during certain points in time acetaminophen with codeine showed a significant imp
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