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(Ivanhoe Newswire) -- Children with arm fractures fared as well with ibuprofen as they did with acetaminophen with codeine, according to a new study.
Amy Drendel, D.O., assistant professor of pediatrics at the Medical College of Wisconsin, Milwaukee, and Children's Research Institute led the study. "Our study calls into question the practice of using acetaminophen with codeine as a rescue medicine if ibuprofen fails to treat fracture pain for children," Dr. Drendel was quoted as saying.
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This study compared how children ages four to 18 years responded to treatment when prescribed ibuprofen or acetaminophen with codeine for pain. In the two groups, there was no difference in the number of children in whom treatment failed, but children receiving ibuprofen reported better functional outcomes, higher satisfaction, and fewer adverse effects than those receiving acetaminophen with codeine.
In the ibuprofen group, 29.5 percent reported an adverse effect, compared with 50.9 percent of the acetaminophen with codeine group. Additionally, almost 90 percent of children treated with ibuprofen preferred the same treatment for future fractures, compared with only 72 percent of the group who received acetaminophen with codeine.
The clinical trial evaluated, treated and discharged 336 children from the Children's Hospital of Wisconsin emergency department between August 2003 and September 2007.
The study found 93 percent of children received pain medication for arm fractures at home. Both groups received a median of three doses of their respective medicine in the first 72 hours, though some children required up to 16 doses. Pain also affected the ability of these children to function, with 60 percent reporting limitations on the date of injury and almost 30 percent continuing to be limited on the third day.
The treatment was considered a success when the patients reported the pain medication achieved the desired pain reduction, and a failure when the medicine did not work, requiring the child to take a rescue pain medication. The ibuprofen group reported lower incidence of treatment failure than did the acetaminophen group, though the results were not statistically significant.
"The majority of children with simple arm fractures have pain at home significant enough to result in analgesic administration and our study helps clinicians make an informed decision about what medication will work best for children with these injuries once they are sent home," explained Dr. Drendel.
SOURCE: Annals of Emergency Medicine, August 18, 2009
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