Preemptive Analgesia with Ibuprofen and Acetaminophen in Pediatric Lower Abdominal Sugery

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. 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. 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). 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