A randomized, placebo-controlled study of rofecoxib with paracetamol in early post-tonsillectomy pain in adults.

BACKGROUND AND OBJECTIVE: Effective and early treatment of postoperative pain and nausea have become pivotal for the early discharge of patients after tonsillectomy. Opioid-based analgesia is standard practice but the use of non-steroidal anti-inflammatory drugs is discouraged due to their platelet inhibiting properties. The cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drugs are effective analgesics and do not affect platelet function. We hypothesized that premedication with cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug in addition to paracetamol would provide effective analgesia and decrease opioid consumption during early recovery from tonsillectomy. METHODS: In a randomized, placebo-controlled study of adult tonsillectomy patients (n=40) one group (R-group; n=20) was premedicated with paracetamol 1.5 g and rofecoxib 50 mg and a control group (P-group; n=20) was premedicated with paracetamol 1.5 g and placebo. Morphine was used as rescue medication. Postoperative (24 h) pain scores (0--10), morphine consumption as well as intraoperative blood loss were recorded. RESULTS: We found no overall difference in pain scores between the groups but significantly more patients in the placebo group had pain scores >5 within the first 8 h. The rofecoxib group consumed less morphine during the first 12 h. A lower intraoperative blood loss was observed in the rofecoxib group. CONCLUSION: Our results suggest an early although clinically minor analgesic benefit of the addition of a cyclo-oxygenase-2 selective non-steroidal anti-inflammatory drug to paracetamol as premedication for adult tonsillectomy.

The incidence of hearing disorders in the schoolchildren of Trinidad.

Two thousand forty-seven (2047) ears of elementary school children of the Republic of Trinidad were screened with pure-tone and immitance tests. Approximately 20 percent of the ears showed type B and C tympanograms, compared with only 2 percent failing a 30 dB, 4 K Hz pure tone. In 13 percent an ipsilateral middle ear muscle reflex could not be elicited. Results are reported in terms of the subjects' racial background. This study tends to support the theory of a genetic origin of otitis media.

The incidence of hearing disorders in schoolchildren of Trinidad

Two thousand forty-seven (2047) ears of elementary school childern of the Republic of Trinidad were screened with pure-tone and immitance tests. Approximately 20 percent of the ears showed type B and C tympanograms, compared with only 2 percent failing a 30dB, 4 KHz tone. In 13 percent an ipsilateral middle ear muscle reflex could not be elicted. Results are reported in terms of the subjects' racial background. This study tends to support the theory of a genetic origin of otitis media. (AU)