| Title: |
Opioid Analgesia Following Pediatric Adenotonsillectomy: A Randomized Clinical Trial |
| Authors: |
Whelan, Rachel L.; McCoy, Jennifer L.; Mirson, Leonid; Maguire, Raymond C.; Jabbour, Noel; Simons, Jeffrey P.; Dohar, Joseph E.; Kitsko, Dennis J.; Stapleton, Amanda L.; Tobey, Allison B.J.; Alper, Cuneyt M.; Shaffer, Amber D.; Bennett, Zachary R.; Chi, David H. |
| Source: |
Otolaryngology–Head and Neck Surgery ; volume 173, issue 2, page 392-401 ; ISSN 0194-5998 1097-6817 |
| Publisher Information: |
Wiley |
| Publication Year: |
2025 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Objective To compare the safety and efficacy of nonopioid versus opioid pain management following adenotonsillectomy (AT) among pediatric patients. Study Design An open‐label randomized controlled trial. Setting Tertiary care children's hospital. Methods Patients aged 3 to 17 years undergoing AT were eligible. Participants were randomly assigned to receive either acetaminophen and ibuprofen (nonopioid group) or acetaminophen, ibuprofen, and oxycodone (opioid group). Pain scores and prevalence of emergency department (ED) visits, hospital readmission, and posttonsillectomy hemorrhage (PTH) were compared between groups. Results From January 2019 to March 2020, 267 patients were enrolled and randomly assigned; 144 completed a postoperative pain diary. Of the 144, 69 (48%) patients received an opioid prescription, and 75 (52%) did not. Mean pain scores before (opioid: 5.78, 95% CI: 5.29‐6.27 vs nonopioid: 5.66, 95% CI: 5.20‐6.12) and after (opioid: 2.33, 95% CI: 1.89‐2.78 vs nonopioid: 2.24, 95% CI: 1.82‐2.66) analgesics were not significantly different between opioid and nonopioid groups. Although 7/75 (9%) from the nonopioid group crossed over and requested opioids, only 43/69 (62%) randomly assigned to receive opioid prescription consumed opioids. The rate of opioid consumption increased with increasing age: 18/71 (25%) patients aged 3 to 7 years, 22/57 (39%) 8 to 12 years, and 10/16 (63%) 13 to 17 years, P = .015. Differences in ED visits, hospital readmissions, and PTH between opioid and nonopioid groups were not significant. Conclusion Many children do not require opioid analgesics following AT, particularly children less than 8 years of age. Postoperative pain scores and outcomes were similar in opioid versus nonopioid groups. Opioid prescriptions should be limited or avoided altogether after pediatric AT. Trial Registration Title: Nonopioids for analgesia after adenotonsillectomy in children; ID: NCT03618823, Clinicaltrials.gov . |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1002/ohn.1280 |
| Availability: |
https://doi.org/10.1002/ohn.1280; https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/ohn.1280 |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.ED08418C |
| Database: |
BASE |