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Do children undergoing bilateral myringotomy with placement of ventilating tubes benefit from pre-operative analgesia? A double-blinded, randomised, placebo-controlled trial

Published online by Cambridge University Press:  12 July 2018

B McHale ,
C D Badenhorst ,
C Low  and
D Blundell
B McHale
Affiliation:
Department of General Medicine, Rotorua Hospital, New Zealand
C D Badenhorst*
Affiliation:
Department of Anaesthesia, Wellington Hospital, New Zealand
C Low
Affiliation:
Department of Otolaryngology, Tauranga Hospital, New Zealand
D Blundell
Affiliation:
Department of Anaesthesia, Rotorua Hospital, New Zealand
*
Author for correspondence: Dr Christopher Badenhorst, 88 South Karori Road, Karori, Wellington 6012, New Zealand E-mail: chrisdean584@gmail.com
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Abstract

Objective

A double-blinded, randomised, placebo-controlled trial was conducted to determine whether routine pre-operative analgesia is beneficial in reducing post-operative ear pain following bilateral myringotomy and tube placement.

Methods

Forty-five children (aged 3–15 years) were randomised to receive either pre-operative analgesics (paracetamol and ibuprofen) (n = 21) or placebo (n = 24). All children underwent sevoflurane gas induction with intranasal fentanyl (2 mcg/kg) to reduce the incidence of emergence agitation. Post-operative pain scores were measured using the Wong-Baker Faces Pain Rating Scale. Median pain scores taken 90 minutes post-surgery, and the highest pain score recorded prior to 90 minutes, were analysed.

Results

There were no statistical differences between the median pain scores at 90 minutes or subsequent need for rescue analgesia. Emergence agitation did not occur in any child. Inadvertent ear trauma, use of an intravenous cannula or airway adjunct did not affect pain scores.

Conclusion

Routine pre-operative analgesia does not reduce pain scores in the early post-operative period. Simple analgesics are effective for rescue analgesia in the minority of cases.

Keywords

ChildAnesthesiaPainPain ManagementAnalgesiaAcetaminophenIbuprofenFentanylEmergence DeliriumMiddle Ear Ventilation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 8 , August 2018 , pp. 685 - 692
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr C Badenhorst takes responsibility for the integrity of the content of the paper

Presented at the 67th Annual General and Scientific Meeting of New Zealand Otolaryngology and Head and Neck Surgery, 13–16 October 2014, Rotorua, New Zealand.

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