Comparison of Celecoxib and Acetaminophen for Pain Relief in Pediatric Day Case Tonsillectomy: A Randomized Double-blind Study

Overview

Journal Laryngoscope Investig Otolaryngol

Publisher Wiley

Specialty Otorhinolaryngology

Date 2021 Dec 23

PMID 34938867

Citations 1

Authors

Mohammad Faramarzi

Sareh Roosta

Mohammad Hossein Eghbal

Bahar Nouri Rahmatabadi

Ali Faramarzi

Soliman Mohammadi-Samani

Mahmood Shishegar

Mohammad Ali Sahmeddini

Affiliations

Soon will be listed here.

Abstract

Objective: Post-tonsillectomy pain is a common morbidity in children. The aim of this study was to compare the efficacy of celecoxib with acetaminophen on pain relief in pediatric day-case tonsillectomy.

Methods: We compared the analgesic effect of celecoxib (99 patients) with acetaminophen (100 patients) for the management of post-tonsillectomy pain. Post-tonsillectomy pain score was evaluated three times a day for 7 days. In addition, the incidence of post-tonsillectomy bleeding and the rate of patients who returned to regular diet were evaluated.

Results: In the first day, we observed lower mean pain score in the celecoxib group, than the acetaminophen group ( = 0.013). The overall pain score in other days was not significantly different between the two groups. In the celecoxib group, more patients resumed regular amount of oral intake within the first 3 days. Also, the rate of post-tonsillectomy bleeding in the two groups was not statistically different.

Conclusion: We recommend celecoxib as a more suitable choice than acetaminophen for post-tonsillectomy pain management in the first day and resuming regular diet within 3 days.Level of Evidence: 1b.

Citing Articles

Comparison of celecoxib and acetaminophen for pain relief in pediatric day case tonsillectomy: A randomized double-blind study.

Faramarzi M, Roosta S, Eghbal M, Nouri Rahmatabadi B, Faramarzi A, Mohammadi-Samani S Laryngoscope Investig Otolaryngol. 2021; 6(6):1307-1315.

PMID: 34938867 PMC: 8665471. DOI: 10.1002/lio2.685.

References

Baugh R, Archer S, Mitchell R, Rosenfeld R, Amin R, Burns J . Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg. 2011; 144(1 Suppl):S1-30. DOI: 10.1177/0194599810389949. View

Issioui T, Klein K, White P, Watcha M, Coloma M, Skrivanek G . The efficacy of premedication with celecoxib and acetaminophen in preventing pain after otolaryngologic surgery. Anesth Analg. 2002; 94(5):1188-93, table of contents. DOI: 10.1097/00000539-200205000-00025. View

Bean-Lijewski J, Kruitbosch S, Hutchinson L, Browne B . Post-tonsillectomy pain management in children: can we do better?. Otolaryngol Head Neck Surg. 2007; 137(4):545-51. DOI: 10.1016/j.otohns.2007.06.731. View

Khan J, Margarido C, Devereaux P, Clarke H, McLellan A, Choi S . Preoperative celecoxib in noncardiac surgery: A systematic review and meta-analysis of randomised controlled trials. Eur J Anaesthesiol. 2016; 33(3):204-14. DOI: 10.1097/EJA.0000000000000346. View

Alm F, Stalfors J, Nerfeldt P, Ericsson E . Patient reported pain-related outcome measures after tonsil surgery: an analysis of 32,225 children from the National Tonsil Surgery Register in Sweden 2009-2016. Eur Arch Otorhinolaryngol. 2017; 274(10):3711-3722. PMC: 5591799. DOI: 10.1007/s00405-017-4679-4. View

Naesh O, Niles L, GILBERT J, Ammar M, Phibbs P, Phillips A . A randomized, placebo-controlled study of rofecoxib with paracetamol in early post-tonsillectomy pain in adults. Eur J Anaesthesiol. 2005; 22(10):768-73. DOI: 10.1017/s0265021505001274. View

Hamunen K, Kontinen V . Systematic review on analgesics given for pain following tonsillectomy in children. Pain. 2005; 117(1-2):40-50. DOI: 10.1016/j.pain.2005.05.012. View

Davies N, McLachlan A, Day R, Williams K . Clinical pharmacokinetics and pharmacodynamics of celecoxib: a selective cyclo-oxygenase-2 inhibitor. Clin Pharmacokinet. 2000; 38(3):225-42. DOI: 10.2165/00003088-200038030-00003. View

Faramarzi A, Heydari S . Prevalence of Post-tonsillectomy Bleeding as Day-case Surgery with Combination Method; Cold Dissection Tonsillectomy and Bipolar Diathermy Hemostasis. Iran J Pediatr. 2012; 20(2):187-92. PMC: 3446030. View

10.

Lewis S, Nicholson A, Cardwell M, Siviter G, Smith A . Nonsteroidal anti-inflammatory drugs and perioperative bleeding in paediatric tonsillectomy. Cochrane Database Syst Rev. 2013; (7):CD003591. PMC: 7154573. DOI: 10.1002/14651858.CD003591.pub3. View

11.

Windfuhr J, Chen Y, Remmert S . Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg. 2005; 132(2):281-6. DOI: 10.1016/j.otohns.2004.09.007. View

12.

Li X, Zhou M, Xia Q, Li J . Parecoxib sodium reduces the need for opioids after tonsillectomy in children: a double-blind placebo-controlled randomized clinical trial. Can J Anaesth. 2015; 63(3):268-74. DOI: 10.1007/s12630-015-0560-3. View

13.

Dalton Jr J, Schweinle J . Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. Ann Emerg Med. 2006; 48(5):615-23. DOI: 10.1016/j.annemergmed.2006.05.015. View

14.

Castellano P, Gamiz M, Bracero F, Santiago F, Soldado L, Solanellas J . ["Usual" morbidity of pediatric tonsillectomy: a study of 126 cases]. Acta Otorrinolaringol Esp. 2001; 52(5):390-5. DOI: 10.1016/s0001-6519(01)78225-8. View

15.

Wong D, Baker C . Pain in children: comparison of assessment scales. Pediatr Nurs. 1988; 14(1):9-17. View

16.

Sheeran P, Rose J, Fazi L, Chiavacci R, McCORMICK L . Rofecoxib administration to paediatric patients undergoing adenotonsillectomy. Paediatr Anaesth. 2004; 14(7):579-83. DOI: 10.1111/j.1460-9592.2004.01263.x. View

17.

Clark E, Plint A, Correll R, Gaboury I, Passi B . A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma. Pediatrics. 2007; 119(3):460-7. DOI: 10.1542/peds.2006-1347. View

18.

Tan L, Taylor E, Hannam J, Salkeld L, Salman S, Anderson B . Pharmacokinetics and analgesic effectiveness of intravenous parecoxib for tonsillectomy ± adenoidectomy. Paediatr Anaesth. 2016; 26(12):1126-1135. DOI: 10.1111/pan.13009. View

19.

Nikanne E, Kokki H, Salo J, Linna T . Celecoxib and ketoprofen for pain management during tonsillectomy: a placebo-controlled clinical trial. Otolaryngol Head Neck Surg. 2005; 132(2):287-94. DOI: 10.1016/j.otohns.2004.09.005. View

20.

Van Daele D, Bodeker K, Trask D . Celecoxib Versus Placebo in Tonsillectomy: A Prospective, Randomized, Double-Blind Placebo-Controlled Trial. Ann Otol Rhinol Laryngol. 2016; 125(10):785-800. DOI: 10.1177/0003489416654707. View