Influence of preoperative oral ibuprofen on postoperative pain and normal activities in children after ambulatory genito-urinary surgery
Bogaert, Guy × Van Severen, Caroline Luysmans, Pierre Evers, Georges #
Ambulatory Surgery vol:11 issue:1-2 pages:27-31
To investigate the possible advantage of administration of preoperative oral ibuprofen in children on the experience of postoperative pain and resumption of normal activities such as normal sleep and play activity.
Material and methods:
A prospective, randomized, double blind study in 54 children (0–14 years) who underwent an ambulatory urological operation was performed. The children of the experimental group received 1 h prior to surgery, 10 mg/kg oral ibuprofen together with their usual premedication, whereas the children of the control group received only the usual premedication. Anesthesia was conducted with sevoflurane inhalation and either a locoregional caudal block (children <30 kg) or local analgesia (children >30 kg). Immediate postoperative pain was assessed using the Faces Pain Scale and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS behavioral scale). Vomiting and nausea were also assessed. On the first and second postoperative day, the same variables were evaluated, as well as quality of sleep, play and need for pain medication.
After performing subanalysis, it was the older children (10–14 year) from the experimental group who experienced more pain. No significant differences were found regarding vomiting and nausea in the hospital or at home (P > 0.05). The assessments of the parents, children as well as the investigators’ were concordant throughout the study.
Older children (10–14 years) who underwent ambulatory genito-urinary surgery under local anesthesia with sedation required more analgesia than was provided by this regimen. The older children who received preoperative oral ibuprofen (10 mg/kg) demonstrated significantly more pain early postoperative and on the first day at home. This study did not show a difference in postoperative pain, nausea and vomiting, or sleep and play quality up to 2 days after surgery that could be attributed to preoperative oral ibuprofen; however, the number of patients studied may have been too few to detect a difference. The children's and parents’ assessments of pain using the face scale and the investigators’ assessments using the CHEOPS scale were comparable.