NSAIDs don't increase bleeding after tonsillectomy in children

Main Category: Ear, Nose and Throat
Article Date: 20 Apr 2005 - 9:00 PST

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You can give children NSAIDs for pain relief after removing their tonsils because there is no evidence that the drugs significantly increase bleeding.

Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen are used to reduce pain after children have had their tonsils removed. But NSAIDs can reduce the ability of blood platelets to stick together and initiate a blood clot. Consequently there is some concern that using NSAIDs leaves the wound more prone to bleeding.

By looking at 13 trials that involved 955 children, the Cochrane Review Authors concluded that NSAIDs did not significantly alter the number of children who bled so much after the operation that they needed to return to surgery for surgeons to stop it.

Also, fewer children experienced nausea and vomiting if they were given NSAIDs as part of their treatment regime.

"There is no evidence to support withholding NSAIDs for paediatric tonsillectomy," says lead reviewer Dr Mary Carwell, a consultant anaesthetist at North Manchester General Hospital.

Review title: Cardwell et al: Non-steroidal anti-inflammatory drugs and perioperative bleeding in paediatric tonsillectomy. The Cochrane Database of Systematic Reviews 2005 Issue 2.

The Cochrane Library newsletter, 2005, issue 2
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