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Preemptive Analgesia with Ibuprofen and Acetaminophen in Pediatric Lower Abdominal Surgery

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Background: Postoperative pain is a significant problem in pediatrics. Preemptive administration of analgesics has recently emerged as a method to enhance pain management associated with surgery. The objective of this study was to compare the analgesic efficacy of a single-dose of preoperative oral ibuprofen versus acetaminophen in preventing pain after lower abdominal surgery in pediatrics. Methods: In this randomized, double-blind study, following lower abdominal surgery, 75 children, aging 3 to 12 years, were assigned to receive either ibuprofen 20 mg /kg (n=25) or acetaminophen 35 mg/kg (n=25) or placebo (n=25) 2 hours before surgery. Agitation in recovery was measured and postoperative pain was quantified 3 and 24 hours after surgery by Oucher’s scale. The amount of postoperative analgesic needed in the ward was also assessed. Results: It was found that preoperative administration of ibuprofen and acetaminophen can reduce agitation in recovery but there was no difference in the agitation score between ibuprofen and acetaminophen groups (P=0.145). Agitation score was significantly lower in ibuprofen group compared to placebo (P>0.005). Similarly, patients in the acetaminophen group were considerably less agitated than those in the placebo group (P=0.002). No significant difference was observed in pain intensity 3 and 24 hours after operation between the three groups [(P=0.495) and (P=0.582) respectively]. The amount of postoperative analgesic needed during ward hospitalization was not significantly different among the three groups (P>0.005). Conclusion: These results provide evidence that preemptive acetaminophen and ibuprofen may reduce agitation during recovery but they neither improve the postoperative pain nor reduce analgesics consumption in ward Key words: Postoperative analgesia, Acetaminophen, Ibuprofen, Preemptive analgesia


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