Annals of Emergency Medicine
Volume 54, Issue 4 , Pages 553-560 , October 2009

A Randomized Clinical Trial of Ibuprofen Versus Acetaminophen With Codeine for Acute Pediatric Arm Fracture Pain

Presented at the Pediatric Academic Society meeting, May 2008, Honolulu, HI; the Emergency Medicine Research Forum, May 2008, Milwaukee, WI; and the Society of Academic Emergency Medicine meeting, June 2008, Washington, DC.

  • Amy L. Drendel, DO, MS

      Affiliations

    • Pediatric Emergency Medicine Division, Medical College of Wisconsin, Milwaukee, WI
    • Corresponding Author InformationAddress for correspondence: Amy L. Drendel, DO, MS, Pediatric Emergency Medicine, Children's Hospital of Wisconsin, PO Box 1997, Suite C550, Milwaukee, WI 53201-1997; 414-266-6672, fax 414-266-2635
  • ,
  • Marc H. Gorelick, MD, MSCE

      Affiliations

    • Pediatric Emergency Medicine Division, Medical College of Wisconsin, Milwaukee, WI
  • ,
  • Steven J. Weisman, MD

      Affiliations

    • Anesthesiology and Pediatrics, Medical College of Wisconsin, Milwaukee, WI
  • ,
  • Roger Lyon, MD

      Affiliations

    • Pediatric Division of the Section of Orthopedics, Medical College of Wisconsin, Milwaukee, WI
  • ,
  • David C. Brousseau, MD, MS

      Affiliations

    • Pediatric Emergency Medicine Division, Medical College of Wisconsin, Milwaukee, WI
  • ,
  • Michael K. Kim, MD

      Affiliations

    • Pediatric Emergency Medicine Division, Medical College of Wisconsin, Milwaukee, WI

Received 2 March 2009 ,Revised 30 April 2009 ,Accepted 15 May 2009.

References 

  1. Oakley EA, Ooi KS, Barnett PL. A randomized controlled trial of 2 methods of immobilizing torus fractures of the distal forearm. Pediatr Emerg Care. 2008;24:65–70
  2. Drendel AL, Lyon R, Bergholte J, et al. Outpatient pediatric pain management practices for fractures. Pediatr Emerg Care. 2006;22:94–99
  3. Plint AC, Perry JJ, Correll R, et al. A randomized, controlled trial of removable splinting versus casting for wrist buckle fractures in children. Pediatrics. 2006;117:691–697
  4. Peter E, Janssen p, Grange C, et al. Ibuprofen versus acetaminophen with codeine for the relief of perineal pain after childbirth: a randomized controlled trial. CMAJ. 2001;165:1203–1209
  5. Wittenberg M, Kinney K, Black J. Comparison of ibuprofen and acetaminophen-codeine in postoperative foot pain. J Am Podiatry Assoc. 1984;74:233–237
  6. Forbes J, Kehm C, Grodin C, et al. Evaluation of ketoralac, ibuprofen, acetaminophen, and acetaminophen-codeine combination in postoperative oral surgery pain. Pharmacotherapy. 1990;10:94S–105S
  7. Raeder J, Steine S, Vatsgar T. Oral ibuprofen versus paracetamol plus codeine for analgesia after ambulatory surgery. Anesth Analg. 2001;92:1470–1472
  8. St. Charles C, Matt B, Hamilton M, et al. A comparison of ibuprofen versus acetaminophen with codeine in the young tonsillectomy patient. Otolaryngol Head Neck Surg. 1997;117:76–82
  9. Heidrich G, Slavic-Svircev V, Kaiko R. Efficacy and quality of ibuprofen and acetaminophen plus codeine analgesia. Pain. 1985;22:385–397
  10. Clark E, Plint AC, Correll R, et al. A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma. Pediatrics. 2007;119:460–467
  11. Yen K, Kim M, Stremski ES, et al. Effect of ethnicity and race on the use of pain medications in children with long bone fractures in the emergency department. Ann Emerg Med. 2003;42:41–47
  12. Hicks CL, von Baeyer CL, Spafford PA, et al. The Faces Pain Scale–Revised: toward a common metric in pediatric pain measurement. Pain. 2001;93:173–183
  13. Foster RL, Varni JW. Measuring the quality of children's postoperative pain management: initial validation of the child/parent Total Quality Pain Management (TQPM) instruments. J Pain Symptom Manage. 2002;23:201–210
  14. Bulloch B, Tenenbein M. Assessment of clinically significant changes in acute pain in children. Acad Emerg Med. 2002;9:199–202
  15. Koller DM, Myers AB, Lorenz D, et al. Effectiveness of oxycodone, ibuprofen, or the combination in the initial management of orthopedic injury-related pain in children. Pediatr Emerg Care. 2007;23:627–633
  16. Mitchell A, van Zanten SV, Inglis K, et al. A randomized controlled trial comparing acetaminophen plus ibuprofen versus acetaminophen plus codeine plus caffeine after outpatient general surgery. J Am Coll Surg. 2008;206:472–479Epub 2007 Nov 26
  17. Winnick S, Lucas DO, Hartman AL, et al. How do you improve compliance?. Pediatrics. 2005;115:e718–e724
  18. Matsui DM. Drug compliance in pediatrics (Clinical and research issues). Pediatr Clin North Am. 1997;44:1–14
  19. Matsui D, Joubert GI, Dykxhoorn S, et al. Compliance with prescription filling in the pediatric emergency department. Arch Pediatr Adolesc Med. 2000;154:195–198
  20. Drendel AL. Pharmacogenomics of analgesic agents. Clin Pediatr Emerg Med. 2007;8:262–267
  21. Chen ZR, Somogyi AA, Reynolds G, et al. Disposition and metabolism of codeine after single and chronic doses in one poor and seven extensive metabolisers. Br J Clin Pharmacol. 1991;31:381–390
  22. Persson K, Sjostrom S, Sigurdardottir I, et al. Patient-controlled analgesia (PCA) with codeine for postoperative pain relief in ten extensive metabolisers and one poor metaboliser of dextromethorphan. Br J Clin Pharmacol. 1995;39:182–186
  23. Poulsen L, Riishede L, Brosen K, et al. Codeine in post-operative pain (Study of the influence of sparteine phenotype and serum concentrations of morphine and morphine-6-glucuronide). Eur J Clin Pharmacol. 1998;54:451–454
  24. Treluyer JM, Jacqz-Aigrain E, Alvarez F, et al. Expression of CYP2D6 in developing human liver. Eur J Biochem. 1991;202:583–588
  25. Blake MJ, Gaedigk A, Pearce RE, et al. Ontogeny of dextromethorphan O- and N-demethylation in the first year of life. Clin Pharmacol Ther. 2007;81:510–516
  26. Williams DG, Patel A, Howard RF. Pharmacogenetics of codeine metabolism in an urban population of children and its implications for analgesic reliability. Br J Anaesth. 2002;89:839–845
  27. Wheeler P, Batt ME. Do non-steroidal anti-inflammatory drugs adversely affect stress fracture healing? (a short review). Br J Sports Med. 2005;39:65–69
  28. Clarke S, Lecky F. Do non-steroidal anti-inflammatory drugs cause a delay in fracture-healing?. Emerg Med J. 2005;22:652–653

 Provide feedback on this article at the journal's Web site, www.annemergmed.com.

 Supervising editor: Knox H. Todd, MD, MPH

 Author contributions: ALD, MHG, SJW, RL, DCB, and MKK conceived the study and designed the trial. ALD and MKK obtained research funding and supervised the conduct of the trial and data collection. ALD managed the data, including quality control. MHG provided statistical advice on study design and assisted ALD in analyzing the data; ALD drafted the article, and all authors contributed substantially to its revision. ALD takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. From July 2003 to July 2005, the Children's Hospital Foundation, Milwaukee, WI, provided $4,500 towards gift cards that were given to patients who completed the study.

 Reprints not available from the authors.

 Dr. Kim is currently affiliated with the University of Wisconsin School of Medicine and Public Health, Madison, WI.

 Publication date: Available online August 18, 2009.

PII: S0196-0644(09)00612-X

doi: 10.1016/j.annemergmed.2009.06.005

Annals of Emergency Medicine
Volume 54, Issue 4 , Pages 553-560 , October 2009