Release: May 12, 2000
Contact: Kenneth Satterfield, 407-238-4161 (as of 5/12/2000)
CODEINE OFFERS NO BETTER PAIN RELIEF FOR CHILDREN RECOVERING FROM A TONSILLECTOMY AND ADENOIDECTOMY
A new research study establishes that acetaminophen is just as effective as acetaminophen with codeine but without the painful side effects
Orlando, FL -- Acetaminophen and acetaminophen with codeine are two of the most common analgesics used to alleviate a child's pain following a tonsillectomy and adenoidectomy. However, previous studies designed to compare the efficacy of both in offering pain relief have been confined to adults undergoing oral surgery with dental extractions.
Now, a research team from Stanford University Medical Center has determined that there is no significant difference in the pain relief provided by the two medications when administered to children who have undergone a tonsillectomy and adenoidectomy. The consequence is that children receiving acetaminophen alone may avoid the side effects to their digestive process that occur when codeine is taken.
The authors of the study, "Acetaminophen versus Acetaminophen with Codeine after Pediatric Tonsillectomy," are Melinda S. Moir, MD, Anna Messner, MD, Ellen Bair, RN, and Pam Shinnick, RN, all from the Division of Otolaryngology--Head and Neck Surgery, Stanford University Medical Center, Stanford, CA. Their findings were presented before The American Laryngological, Rhinological, and Otological Society (Triological Society), meeting May 15-17, in Orlando, FL.
Methodology: Fifty-one children scheduled for outpatient tonsillectomy and adenoidectomy were included in the study. Parents preoperatively were randomly given a sealed envelope with a prescription for acetaminophen elixir (15 mg/kg) or acetaminophen (9.6 mg/kg) with codeine elixir (1 mg/kg) to be administered every four hours postoperatively as needed for pain.
Parents and investigators remained blinded to the contents; food coloring was used by the pharmacy, so that medications had the same appearance. Parents who contacted physicians postoperatively requesting alternative pain medication received either acetaminophen with codeine or ibuprofen, keeping the identity of the study medication blinded.
After the surgery, the parents were given a series of questions to be completed daily for a total of ten days. The questionnaire utilized the Wong-Baker faces pain rating scale to assist children in quantifying their pain (the scale contains six faces which are assigned numeric values; a zero denotes no pain and a ten represents the worst pain possible, a crying face). The parents and child were asked to indicate the level of discomfort displayed. Parents were asked to record daily the number of doses administered, nighttime awakenings, episodes of nausea, emesis, or constipation, and percentage of diet consumed.
Results: Fifty one children participated in the study, 31 in the acetaminophen group and 20 in the acetaminophen with codeine were included in the data analysis. Sixty-one percent of the patients were male, 39 percent, female. The mean age of the children was 5.7 years and 5.3 in the codeine group. Three children in the acetaminophen group and five in the acetaminophen with codeine had bilateral myringotomies with ventilation tube insertion at the time of their tonsillectomy and adenoidectomy.
Key findings include:
ï There was no difference in the mean pain level between the acetaminophen group and the acetaminophen with codeine group at any point during the postoperative period.
ï Children administered acetaminophen with codeine incurred more problems with nausea, emesis, and constipation. Conversely, children provided acetaminophen has less digestive problems and therefore consumed more of their diet.
The authors believe that these findings bring otolaryngologist--head and neck surgeons new information regarding two commonly used analgesics. This information will assist in counseling parents regarding appropriate pain management.
- end -
RSS