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Because of reports of fatalities, codeine is not recommended for analgesia after tonsillectomy. To determine the safety and effectiveness of acetaminophen combined with morphine or ibuprofen for posttonsillectomy analgesia, investigators compared respiratory events before and after surgery in 91 children 1 to 10 years of age undergoing tonsillectomy, with or without adenoidectomy, for obstructive sleep apnea. Patients were randomized to acetaminophen with either oral ibuprofen (10 mg/kg every 6 hours) or oral morphine (0.2–0.5 mg/kg every 4 hours), as needed. Parents were instructed to use pulse oximeters to monitor their child's respiratory parameters.
Acetaminophen was used for a mean of 4.5 days in the ibuprofen group and 4.9 days in the …