Nonsteroidal Antiinflammatory Drugs and Perioperative Bleeding in Pediatric Tonsillectomy

Cardwell, Mary; Siviter, Gretchen; Smith, Andrew H.

doi:10.1097/00000539-200511000-00057

Cited by 11 publications

(8 citation statements)

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“…Dexamethasone has been linked to post-tonsillectomy bleeding [25] but its role, and the role of NSAIDs, in causing secondary haemorrhage is yet to be determined. [26], [27] However, intra-operative steroids have played a major role in improving post-operative nausea and vomiting in children. [26], [28] …”

Section: Discussionmentioning

confidence: 99%

Adverse Drug Reactions Causing Admission to a Paediatric Hospital

et al. 2012

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Objective(s)To obtain reliable information about the incidence of adverse drug reactions, and identify potential areas where intervention may reduce the burden of ill-health.DesignProspective observational study.SettingA large tertiary children’s hospital providing general and specialty care in the UK.ParticipantsAll acute paediatric admissions over a one year period.Main ExposureAny medication taken in the two weeks prior to admission.Outcome MeasuresOccurrence of adverse drug reaction.Results240/8345 admissions in 178/6821 patients admitted acutely to a paediatric hospital were thought to be related to an adverse drug reaction, giving an estimated incidence of 2.9% (95% CI 2.5, 3.3), with the reaction directly causing, or contributing to the cause, of admission in 97.1% of cases. No deaths were attributable to an adverse drug reaction. 22.1% (95% CI 17%, 28%) of the reactions were either definitely or possibly avoidable. Prescriptions originating in the community accounted for 44/249 (17.7%) of adverse drug reactions, the remainder originating from hospital. 120/249 (48.2%) reactions resulted from treatment for malignancies. The drugs most commonly implicated in causing admissions were cytotoxic agents, corticosteroids, non-steroidal anti-inflammatory drugs, vaccines and immunosuppressants. The most common reactions were neutropenia, immunosuppression and thrombocytopenia.ConclusionsAdverse drug reactions in children are an important public health problem. Most of those serious enough to require hospital admission are due to hospital-based prescribing, of which just over a fifth may be avoidable. Strategies to reduce the burden of ill-health from adverse drug reactions causing admission are needed.

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Section: Discussionmentioning

confidence: 99%

Adverse Drug Reactions Causing Admission to a Paediatric Hospital

et al. 2012

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“…Little data exist about assessing acute bleeding risk after trauma, but to extrapolate from surgical literature, multiple studies have shown that no increase in postoperative bleeding occurs with short-term use of NSAIDs. 25,26 Although prolonged use can cause peptic ulcer disease, short-term use for up to 10 days of over-the-counter NSAIDs with standard dosing has been shown to be extremely safe and well tolerated. [27][28][29] An ibuprofen dose of 1200 mg/d or less or naproxen at 660 mg/d or less has no greater risk than placebo.…”

Section: Nonopioid Analgesiamentioning

confidence: 99%

Wilderness Medical Society Practice Guidelines for the Treatment of Acute Pain in Remote Environments: 2014 Update

Russell

Scaife

Weber

et al. 2014

Wilderness & Environmental Medicine

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The Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the management of pain in austere environments. Recommendations are graded on the basis of the quality of supporting evidence as defined by criteria put forth by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for the Treatment of Acute Pain in Remote Environments published in Wilderness & Environmental Medicine 2014;25(1):41-49.

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“…Little data exist about assessing acute bleeding risk after trauma, but to extrapolate from surgical literature, multiple studies have shown that no increase in postoperative bleeding occurs with short-term use of NSAIDs. 25,26 Although prolonged use can cause peptic ulcer disease, short-term use for up to 10 days of over-the-counter NSAIDs with standard dosing has been shown to be extremely safe and well tolerated. [27][28][29] An ibuprofen dose of 1200 mg/day or less or naproxen at 660 mg/d or less has no greater risk than placebo.…”

Section: Nonopioid Analgesiamentioning

confidence: 99%