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Safety Study of Post Tonsillectomy Ibuprofen Use in Adults

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Brooke Army Medical Center

Status

Unknown

Conditions

Primary Post Tonsillectomy Hemorrhage
Secondary Post Tonsillectomy Hemorrhage

Treatments

Drug: Ibuprofen

Study type

Interventional

Funder types

Other U.S. Federal agency

Identifiers

Details and patient eligibility

About

The purpose of this study is to determine if ibuprofen use after electrocautery tonsillectomy increases the post-tonsillectomy hemorrhage rate.

Hypothesis: Use of ibuprofen does not increase the post-tonsillectomy hemorrhage rate.

Primary outcome: Rate of tonsillar hemorrhage following adult tonsillectomy in those receiving narcotic pain medications plus ibuprofen compared to those receiving narcotics alone.

Secondary outcome: Determine whether ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), decreases post tonsillectomy pain, narcotic pain medication use, or cost of pain management.

Full description

Tonsillectomy is common procedure associated with significant post-operative pain typically managed by narcotic pain medication. Narcotics, however, can have inherent unwanted side effects such as respiratory depression. In fact, a recent U.S. Food and Drug Administration (FDA) warning has reported deaths from respiratory distress that were associated with use of codeine in children after tonsillectomy. Finding alternative pain management regimens therefore is essential in post-tonsillectomy care. Non-steroidal anti-inflammatory (NSAID) medications may provide an effective alternative to narcotics, but use of NSAIDs routinely after tonsillectomy has been limited due to concern for theoretical increased risk of post-operative bleeding, This is likely true for NSAIDs such as aspirin. NSAIDs such as ibuprofen, however, are believed to have no greater risk of bleeding than baseline, but this has not been proven. Recent, well-designed, prospective pediatric studies have demonstrated effective analgesia improvement with the addition of non-steroidal anti-inflammatory drugs such as ibuprofen to post-operative pain management regimens, and no increased rate of post-surgery bleeding. This has not adequately been studied in adults but could provide many patients significant pain relief in the post-operative period if it is shown to not increase post tonsillectomy hemorrhage rates, as already demonstrated in the pediatric population.

Enrollment

810 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Adults 18 years old or older
  • Scheduled for tonsillectomy

Exclusion criteria

  • Prisoners
  • Pregnancy
  • Allergy to ibuprofen
  • History of vasculopathy to include Lupus or Wegener's or Disseminated Intravascular Coagulation (DIC)
  • Any other bleeding disorder to include Von Willebrand Disease and others
  • Active Neoplasm of any kind
  • Tonsillectomy in combination with any sleep surgical procedure or palatal procedure

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Triple Blind

810 participants in 2 patient groups, including a placebo group

Ibuprofen
Experimental group
Description:
800mg ibuprofen every 8 hours prn pain.
Treatment:
Drug: Ibuprofen
Methylcellulose Powder
Placebo Comparator group
Description:
Subjects receive inert methylcellulose powder as placebo

Trial contacts and locations

3

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Central trial contact

Thomas J Willson, MD; Gregory R Dion, MD, MS

Data sourced from clinicaltrials.gov

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