The effect of ibuprofen on postoperative hemorrhage following tonsillectomy in children

Abstract

The objective of the study was to evaluate the effect of ibuprofen on hemorrhage after tonsillectomy in children. All charts of children, who underwent tonsillectomy with or without adenoidectomy, were reviewed. The age at the time of surgery ranged between 3 and 16 years (mean age = 7.55 ± 3.01 years). Children were divided into two groups based on the drugs used for postoperative pain relief. Group I received paracetamol after surgery. Group II received ibuprofen after surgery. A total of 62 patients received ibuprofen and 109 patients were given paracetamol. Post-tonsillectomy hemorrhage occurred in seven (4.1%) children, primary hemorrhage was noted in five patients and secondary hemorrhage occurred in two patients. While 3 of 62 children (4.8%) who were given ibuprofen had postoperative hemorrhage, 4 of 109 patients (3.7%) who were given paracetamol had hemorrhage There was no significant difference in hemorrhage rates between these two groups (p > 0.05). Hemorrhage following tonsillectomy is rare and frequently occurs in the early postoperative period. There is no significant increased risk of hemorrhage after ibuprofen administration and it can be used safely for post-tonsillectomy pain relief.

Postoperative nonsteroidal anti-inflammatory drugs and risk of bleeding in pediatric intracapsular tonsillectomy

“…[6][7][8][9][10] In a 2003 study by Marrett, the preoperative use of NSAIDs was associated with increased risk of reoperation for hemostasis versus those who received placebo or narcotic. 6 A study by Møiniche that same year found that postoperative NSAID use leads to increased likelihood of having a PTH requiring reoperation.…”

Intoxication à la morphine en pédiatrie : un cas clinique

“…Les hémorragies qui font suite à cette intervention sont rares et varient entre 0,7 et 4 %, mais les conséquences d'un saignement oropharyngé peuvent être fatales 9 . Au Québec, 9000 amygdalectomies sont pratiquées chaque année, et un enfant sur 20 000 en décède 8 .…”

Toward Adenotonsillectomy in Children

“…53 While there is a theoretical risk of ibuprofen use leading to increased postoperative bleeding, this adverse event has not been observed in several trials. [54][55][56][57] There is evidence that ketorolac and aspirin are associated with increased bleeding risk. 54,57 The benefit of fixed vs as-needed schedules for analgesics is unresolved, but results from one trial did demonstrate superior pain control with a fixed schedule.…”