Preemptive Analgesia with Ibuprofen and Acetaminophen in Pediatric Lower Abdominal Surgery

Postoperative pain is a significant problem in pediatrics. preemptive administration of analgesics has recently emerged as a method to enhance pain management associated with surgery. the objective of this study was to compare the analgesic efficacy of a single-dose of preoperative oral ibuprofen versus acetaminophen in preventing pain after lower abdominal surgery in pediatrics.methods: in this randomized, double-blind study, following lower abdominal surgery, 75 children, aging 3 to 12 years, were assigned to receive either ibuprofen 20 mg /kg (n=25) or acetaminophen 35 mg/kg (n=25) or placebo (n=25) 2 hours before surgery. agitation in recovery was measured and postoperative pain was quantified 3 and 24 hours after surgery by oucher's scale. the amount of postoperative analgesic needed in the ward was also assessed.results: it was found that preoperative administration of ibuprofen and acetaminophen can reduce agitation in recovery but there was no difference in the agitation score between ibuprofen and acetaminophen groups (p=0.145). agitation score was significantly lower in ibuprofen group compared to placebo (p>0.005). similarly, patients in the acetaminophen group were considerably less agitated than those in the placebo group (p=0.002). no significant difference was observed in pain intensity 3 and 24 hours after operation between the three groups [(p=0.495) and (p=0.582) respectively]. the amount of postoperative analgesic needed during ward hospitalization was not significantly different among the three groups (p>0.005).conclusion: these results provide evidence that preemptive acetaminophen and ibuprofen may reduce agitation during recovery but they neither improve the postoperative pain nor reduce analgesics consumption in ward