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Anita Jeyakumar, MD; Todd M. Brickman, MD; Mary E. Williamson, MD; Keiko Hirose, MD; Paul Krakovitz, MD; Kenneth Whittemore, MD; Christopher Discolo, MD

Arch Otolaryngol Head Neck Surg. 2008;134(1):24-27.

Objective  To assess the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on bleeding for pediatric adenotonsillectomy in a retrospective study, based on the common practices at 2 different tertiary care facilities.

Design  A retrospective study.

Setting  Two different tertiary care facilities.

Patients  Children up to 16 years of age, who underwent elective adenotonsillectomy or tonsillectomy, were included in the study. All indications for adenotonsillectomy, and all surgical techniques were included. Children with a bleeding tendency, and those with contraindications to the use of NSAIDs (eg, because of allergy), were excluded from the study.

Interventions  Nonsteroidal anti-inflammatory drugs.

Main Outcome Measure  Postoperative bleeding in patients.

Results  A total of 1160 patients were selected who met the criteria: 673 patients underwent an adenotonsillectomy or tonsillectomy and did not receive any preoperative and postoperative ibuprofen, and 487 patients underwent routine adenotonsillectomy or tonsillectomy and were given postoperative ibuprofen. We noted a 0.7% postoperative bleeding rate in patients who were not allowed to take ibuprofen perioperatively. There was a 1.0% postoperative bleeding rate in patients who were allowed to take ibuprofen perioperatively (P = .75).

Conclusion  Ibuprofen is not a contraindication to adenotonsillectomy or tonsillectomy and should be used in the control of postoperative pain if it is indicated in the patient.

Author Affiliations: Departments of Otolaryngology, Washington University School of Medicine, St Louis, Missouri (Drs Jeyakumar and Brickman); The Cleveland Clinic Foundation, Cleveland, Ohio (Drs Williamson, Hirose, Krakovitz, and Discolo); and University of Rochester, Rochester, New York (Dr Whittemore).