Safety Study of Post Tonsillectomy Ibuprofen Use in Adults

Primary Outcome Measures:

• clinically defined tonsil bleed rate (percentage) [ Time Frame: 2 weeks ] [ Designated as safety issue: Yes ]
  A post tonsillectomy hemorrhage/bleed, for the purposes of this study, is defined as a postoperative bleed requiring anything more than medicinal intervention (cauterization of any kind, suture, evaluation in operating room).
  
  

Secondary Outcome Measures:

• Hospital readmission rate (percentage) [ Time Frame: 2 weeks ] [ Designated as safety issue: No ]
  
• Subclinical (not requiring intervention) subjectively reported tonsil bleed rate (percentage) [ Time Frame: 2 weeks ] [ Designated as safety issue: No ]
  Subjects will report on followup survey if they had post operative oral bleeding more than streaked blood in their spit for which they did not go to the hospital or clinic for treatment of.
  
  
• Pain scale rating [ Time Frame: 2 Weeks ] [ Designated as safety issue: No ]
  Subjects will answer a visual analog scale (VAS) Pain scale for days 1, 3, 7, and 14 after tonsillectomy.
  
  
• Nausea Scale [ Time Frame: 2 weeks ] [ Designated as safety issue: No ]
  Subjects will answer a VAS nausea scale for days 1, 3, and 7 after tonsillectomy.
  
  

Tonsillectomy is common procedure associated with significant post-operative pain typically managed by narcotic pain medication. Narcotics, however, can have inherent unwanted side effects such as respiratory depression. In fact, a recent U.S. Food and Drug Administration (FDA) warning has reported deaths from respiratory distress that were associated with use of codeine in children after tonsillectomy. Finding alternative pain management regimens therefore is essential in post-tonsillectomy care. Non-steroidal anti-inflammatory (NSAID) medications may provide an effective alternative to narcotics, but use of NSAIDs routinely after tonsillectomy has been limited due to concern for theoretical increased risk of post-operative bleeding, This is likely true for NSAIDs such as aspirin. NSAIDs such as ibuprofen, however, are believed to have no greater risk of bleeding than baseline, but this has not been proven. Recent, well-designed, prospective pediatric studies have demonstrated effective analgesia improvement with the addition of non-steroidal anti-inflammatory drugs such as ibuprofen to post-operative pain management regimens, and no increased rate of post-surgery bleeding. This has not adequately been studied in adults but could provide many patients significant pain relief in the post-operative period if it is shown to not increase post tonsillectomy hemorrhage rates, as already demonstrated in the pediatric population.