The effect of paracetamol, metamizole sodium and ibuprofen on postoperative hemorrhage following pediatric tonsillectomy

Objective: To determine the risk of postoperative hemorrhage associated with the use of analgesic drugs including paracetamol, metamizole sodium and ibuprofen after pediatric tonsillectomy. Patients and methods: Three hundred and forty consecutive children with recurrent tonsillitis and/or obstructive symptoms were included in the study. Children were divided into three groups based on the drugs used for postoperative pain relief. Each group received paracetamol, metamizole sodium and ibuprofen following the surgery. The study of population was compared respect to postoperative bleeding. Chi-square test was used for statistical analysis. Results: A total of 115 patients received ibuprofen, 115 patients were given metamizole sodium and 110 patients were given paracetamol. Posttonsillectomy hemorrhage occurred in fourteen (4.11%) children, consisting of primary hemorrhage in two patients and secondary hemorrhage in twelve patients. While 6 of 115 children (5.21%) who were given ibuprofen had postoperative hemorrhage, 4 of 115 children (3.47%) in metamizole sodium group and 4 of 110 patients (3.63%) in paracetamol group had hemorrhage. There was no significant difference with respect to hemorrhage rates between these three groups (p<0.05). Conclusion: In our study we could not show significant risk of hemorrhage after using of ibuprofen, metamizole sodium and paracetamol administration and they can be used safely for posttonsillectomy pain. (C) 2012 Elsevier Ireland Ltd. All rights reserved.