Navigation Links
Over-the counter as effective as Rx at managing post-tonsillectomy pain

DETROIT -- You may be able to eat all of the ice cream you want after having your tonsils removed, but researchers at Henry Ford Hospital in Detroit say you don't necessarily need a prescription to reduce post-operative pain -- an over-the-counter pain-reliever is just as effective.

The study shows over-the-counter ibuprofen manages pain after a tonsillectomy for children and adults as well as the prescription pain medications acetaminophen with hydrocodone and acetaminophen with codeine, which is no longer recommended for use in children.

"Based on this study and the FDA warning about the risks of children taking any medication with codeine, we recommend that children receive over-the-counter ibuprofen after a tonsillectomy," says lead study author Robert T. Standring, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.

"Ibuprofen appears to be the safest alternative that still provides adequate pain control for children."

Study results will be presented Tuesday, Oct. 1 at the 2013 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) annual meeting in Vancouver, BC.

Tonsillectomy, the surgical removal of the tonsils, is the second most common out-patient surgery for children younger than age 15. Each year, an estimated 662,000 children undergo a tonsillectomy.

Pain is the primary source of illness following a tonsillectomy, causing dehydration, difficulty and painful swallowing, and weight loss. These symptoms can lead to increased post-operative visits and hospital readmission.

In 2012, the FDA recommended that children not be given medication with codeine due to associated risks. Additionally, in 2011 the AAO-HNS published a clinical Practice Guideline on tonsillectomy in children, recommending a weight-based pain regimen be given based on pain scores of patient.

With these changes, the Henry Ford study sought to investigate a safe and effective oral post-operative pain regimen for both children and adults following tonsillectomy.

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 improvement in pain.


Contact: Krista Hopson
Henry Ford Health System

Related medicine news :

1. Misuse of over-the-counter pain medication is potential health threat
2. OB/GYNs Endorse Over-the-Counter Birth Control Pills
3. Zane Benefits Publishes Information About Over-the-Counter (OTC) Medicines, Drugs and HRAs
4. First Ever Over-the-Counter Organic Anti-Itch Ointment Developed by US Organic Group Corp.
5. Footlogics Canada Introduces a Revolutionary New Product for Diabetics, the Sensi Diabetic Over-the-Counter Foot Orthotic
6. Footlogics Canada Introduces a Revolutionary New Product for Diabetics, the Sensi Diabetic Over-the-Counter Foot Orthotic
7. Over-the-Counter Wart Remover Wartrol Now at Maximum Strength
8. 70 percent of women use contraceptives during their first sexual encounter
9. Female Doctors Earn Less Than Male Counterparts: Study
10. Health interventions for clergy must counteract need to put others first
11. Nurses need to counteract negative stereotypes of the profession in top YouTube hits
Post Your Comments:
(Date:11/24/2015)... ... November 24, 2015 , ... ... its exceptional customer service: the TrustDale certification. The award recognizes good companies for ... stone honing , tile and grout, and hard surface restoration company earned this ...
(Date:11/24/2015)... ... 24, 2015 , ... Bibliomotion is thrilled to announce the launch ... and Diversity by Nancy M. Schlichting, Chief Executive Officer of Henry Ford ... address the needs of patients and their families, shaped my desire to improve the ...
(Date:11/24/2015)... ... , ... Dr. Kevin Day, local family chiropractor in Warsaw , is ... season. During the Indiana winter months, Vitamin D deficiency can lead to Seasonal ... want to help provide the tools needed to combat it this year! , “Stress ...
(Date:11/24/2015)... ... ... Don Peck’s mother wondered if she was a descendant of Samuel Fuller, a passenger on ... search for information, Don and his aunt discovered that she was not, in fact, related ... was Don’s father who was descended from not one, but four passengers on the famed ...
(Date:11/24/2015)... ... November 24, 2015 , ... World ... Fragrance by Marcelle, a cosmetic invention which offers a combination of natural essential ... in the US is worth $3 billion annually," says Scott Cooper, CEO and ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... F1000Workspace - a research collaboration, reference management and ... six months ago. --> F1000Workspace - a ... since it was launched just six months ago. --> ... F1000Workspace - a research collaboration, reference management and authoring ... months ago. --> --> ...
(Date:11/24/2015)... , Nov. 24, 2015  Family Rentals, ... recently announced the launch of their newly designed, ... --> --> ... --> --> Now, renting ... travel and vacation, just got a whole lot ...
(Date:11/24/2015)... Pa. , Nov. 24, 2015  NuShield, Inc., an industry leader in LCD screen protection ... and stationary computer technology as part of their patient monitoring or electronic documentation system. ... ... ... A ...
Breaking Medicine Technology: