Acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy.

Author(s): Moir MS, Bair E, Shinnick P, Messner A

Affiliation(s): Division of Otolaryngology--Head and Neck Surgery, Stanford University Medical Center, California, USA.

Publication date & source: 2000-11, Laryngoscope., 110(11):1824-7.

Publication type: Clinical Trial; Randomized Controlled Trial

OBJECTIVE: To compare the effectiveness of acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy and adenoidectomy. STUDY DESIGN: Prospective, randomized, double-blind study. METHODS: Fifty-one children ages 3 to 12 years scheduled for outpatient tonsillectomy and adenoidectomy were studied. Patients were randomly assigned to receive acetaminophen or acetaminophen with codeine in unlabeled bottles for postoperative pain control. The Wong-Baker FACES pain rating scale was used to help children quantify their level of pain after surgery. The level of pain, quantity of pain medication required, presence of side effects, and the percentage of a normal diet consumed was recorded for 10 postoperative days. RESULTS: There was no difference (P > .05, all time points) in the level of postoperative pain reported by the parents and children in the two groups. The acetaminophen with codeine group tended to have increased problems with nausea, emesis, and constipation, but these differences did not reach statistical significance. Children in the acetaminophen group consumed a significantly higher percentage of a normal diet on the first 6 postoperative days (P < .05, all time points). CONCLUSION: There was no difference in the level of pain control provided by acetaminophen and acetaminophen with codeine as measured by the Wong-Baker FACES pain rating scale. Postoperative oral intake was significantly higher in children treated with acetaminophen alone.