OTC pain meds as good as Rxs after tonsillectomy

Over-the-counter (OTC) pain relievers are just as effective as prescription pain medications for post-tonsillectomy pain, say researchers from Henry Ford Hospital.

In a small study involving 91 patients, OTC ibuprofen relieved post-tonsillectomy pain in children and adults just as well as acetaminophen with hydrocodone and acetaminophen with codeine, the latter of which is no longer recommended for use in children by the US Food and Drug Administration (FDA).

The study, which was presented at the 2013 annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery in Vancouver, BC, involved patients undergoing tonsillectomy aged from 3 to 38 years.

The investigators randomly gave each of the participants a packet preoperatively containing OTC ibuprofen, acetaminophen with hydrocodone, or acetaminophen with codeine. After the procedure, they asked the participants to record the amount of medication taken, the amount of liquid and food consumed, when they returned to work or school, and if they developed any complications from the procedure or the medication.

Among the 25 patients who completed the assignment, 12 took ibuprofen, 8 took acetaminophen with hydrocodone, and 5 took acetaminophen with codeine. (When the FDA issued its warning about codeine use in children, the researchers stopped enrolling children in that arm of that study.)

Overall, the investigators found no significant differences between the 3 medications in pain control, in time to return to work or school, or in time to resume regular diet and activities. At certain points in time, however, acetaminophen with codeine showed a significant improvement in pain over the other 2 medications.

According to a news release issued by the Henry Ford Health System, at 662,000 per year, tonsillectomy is the second most common outpatient surgery performed in children aged younger than 15 years.

Given the FDA’s warning about codeine use in children and given the results of the current study, the researchers recommend using OTC ibuprofen in children following tonsillectomy. 

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