Ibuprofen for Pain After Tonsil Removal

Pain after tonsillectomy may be treated with ibuprofen just as well as prescription medications

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) While surgery can solve some potentially serious problems, it can also be a painful process to recover from. After surgery to remove tonsils, patients are likely to receive pain medications. But they may not have to turn to strong prescription drugs to relieve their pain.

A recent study found that ibuprofen helped reduce pain about as much as prescription medications in patients who recently had their tonsils removed.

Patients who had taken prescription and non-prescription medications were all able to return to a normal diet, work and school at around the same time after surgery.

According to the researchers, this study provides evidence for a safe, alternative treatment that may help reduce pain in children who recently had their tonsils removed. 

"Ask a pharmacist about medications for pain after tonsillectomy."

Robert Standring, MD, of the Department of Otolaryngology-Head and Neck Surgery in the Henry Ford Health System, and colleagues aimed to examine how effective three different pain medications were for patients who had undergone tonsillectomies.

The US Food and Drug Administration (FDA) issued a warning regarding the possible effects on children of the prescription medication codeine, which is often prescribed to children after tonsillectomies.

This study consisted of 91 pediatric patients, 25 of whom completed a packet that rated their level of pain twice a day. A total of 12 patients were treated with ibuprofen, eight patients with acetaminophen/hydrocodone and five with acetaminophen/codeine.

The patients were asked to rate their pain level on a scale from 1 to 10 based on various pictures of faces twice a day. Patients also were asked to document the amount of pain medication they used and how much food and liquid was consumed each day.

The study documented the average level of pain for patients 10 days following the operation.

There were no significant differences between ibuprofen, acetaminophen/codeine, and acetaminophen/hydrocodone in helping patients return to normal status. 

There were a few time periods of significant improvement in pain when using acetaminophen/codeine. The researchers wrote that this means that all three regimens offer adequate pain control, but acetaminophen/codeine may be slightly better when compared to ibuprofen.

The authors noted that one of the limitations of this study was that only 27 percent of the original participants returned the packets sent out to rate pain levels each day. However, the return rates for this trial were higher than other trials.

Despite this limitation, the researchers were confident about the results of their study.

“Due to the variable metabolism and potential mortality associated with codeine and hydrocodone, it is our recommendation that children receive ibuprofen after tonsillectomy,” the authors of this study concluded.  

"In my experience working with patients over the past 27 years, the initial recovery period of 5-7 days after a tonsillectomy can be quite painful.  Regularly, I see acetaminophen with codeine solution or acetaminophen with hydrocodone solution prescribed as the post-op medication of choice to treat the pain associated with the tonsillectomy," Steve Leuck, PharmD, Owner/President of AudibleRx, told dailyRx News.

"This article, quite appropriately, points out that ibuprofen, at appropriate doses, has been shown to be a reliable alternative to treat post-op tonsillectomy pain and should be considered as an alternative to the opiate based treatments," said Leuck. 

This research was presented on October 1 at the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) annual meeting in Vancouver, BC and was funded by Henry Ford Hospital. All research should be considered preliminary until published in a peer-reviewed journal.

Review Date: 
October 2, 2013
Last Updated:
December 30, 2013