Trial Outcomes & Findings for Management of Post-Tonsillectomy Pain in Pediatric Patients (NCT NCT04551196)

NCT ID: NCT04551196

Last Updated: 2024-07-11

Results Overview

The proportion of FLACC (Faces, Legs, Activity, Cry, and Consolability scale) pain scores ≥7 from POD 1 through POD 3 compared between the combined and the alternating medication regimens. The FLACC scale is scored in a range of 0-10 with 0 representing no pain. The scale has five criteria (Faces, Legs, Activity, Cry, and Consolability), which are each assigned a score of 0, 1 or 2.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

50 participants

Primary outcome timeframe

up to 3 days following consent

Results posted on

2024-07-11

Participant Flow

Eligible candidates scheduled to undergo tonsillectomy at SLCH were approached either in the outpatient setting or preoperative holding area prior to surgery by the study team. Recruitment period was from 3/2020 - 10/2021.

Participant milestones

Participant milestones
Measure
Alternating Regimen
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Overall Study
STARTED
25
25
Overall Study
COMPLETED
25
25
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Management of Post-Tonsillectomy Pain in Pediatric Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Total
n=50 Participants
Total of all reporting groups
Age, Categorical
<=18 years
25 Participants
n=5 Participants
25 Participants
n=7 Participants
50 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Sex: Female, Male
Female
16 Participants
n=5 Participants
10 Participants
n=7 Participants
26 Participants
n=5 Participants
Sex: Female, Male
Male
9 Participants
n=5 Participants
15 Participants
n=7 Participants
24 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
25 Participants
n=5 Participants
23 Participants
n=7 Participants
48 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Race (NIH/OMB)
White
21 Participants
n=5 Participants
20 Participants
n=7 Participants
41 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants

PRIMARY outcome

Timeframe: up to 3 days following consent

The proportion of FLACC (Faces, Legs, Activity, Cry, and Consolability scale) pain scores ≥7 from POD 1 through POD 3 compared between the combined and the alternating medication regimens. The FLACC scale is scored in a range of 0-10 with 0 representing no pain. The scale has five criteria (Faces, Legs, Activity, Cry, and Consolability), which are each assigned a score of 0, 1 or 2.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Number of Participants With FLACC Pain Scores ≥7 From POD 1 Through POD 3
1 participants
1 participants

SECONDARY outcome

Timeframe: 3 separate individual days, will be completed days after the surgery

The proportion of FLACC (Faces, Legs, Activity, Cry, and Consolability scale) pain scores ≥7 on each individual POD 1, 3, and 7 compared between the combined and the alternating medication regimens. The FLACC scale is scored in a range of 0-10 with 0 representing no pain. The scale has five criteria (Faces, Legs, Activity, Cry, and Consolability), which are each assigned a score of 0, 1 or 2.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Number of Participants With FLACC Pain Scores ≥7 on Each Individual POD 1, 3, and 7
1 participants
1 participants

SECONDARY outcome

Timeframe: up to 7 days following consent

The proportion of cumulative FLACC pain scores ≥7 from POD 1 through POD 7 compared between the combined and the alternating medication regimens. The FLACC scale is scored in a range of 0-10 with 0 representing no pain. The scale has five criteria (Faces, Legs, Activity, Cry, and Consolability), which are each assigned a score of 0, 1 or 2.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Number of Participants With FLACC Pain Scores ≥7 From POD 1 Through POD 7
1 participants
1 participants

SECONDARY outcome

Timeframe: 3 separate individual days, will be completed days after the surgery

The proportion of Faces pain scores ≥8 on POD 1, 3, and 7 compared between the combined and the alternating medication regimens. The Faces scale shows a series of faces ranging from a happy face at 0, or "no hurt", to a crying face at 10, which represents "hurts like the worst pain imaginable". Based on the faces and written descriptions, the patient chooses the face that best describes their level of pain.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Number of Participants With Faces Pain Scores ≥8 on POD 1, 3, and 7
1 participants
1 participants

SECONDARY outcome

Timeframe: up to 7 days following consent

The proportion of cumulative Faces pain scores ≥8 from POD 1 through POD 7 compared between the combined and the alternating medication regimens. The Faces scale shows a series of faces ranging from a happy face at 0, or "no hurt", to a crying face at 10, which represents "hurts like the worst pain imaginable". Based on the faces and written descriptions, the patient chooses the face that best describes their level of pain.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Number of Participants With Cumulative Faces Pain Scores ≥8 From POD 1 Through POD 7
3 participants
1 participants

SECONDARY outcome

Timeframe: up to 3 days following consent

The proportion of rescue medication usage from POD 1 through POD 3 compared between the combined and the alternating medication regimens.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Number of Participants With Rescue Medication Usage Through POD 3
3 participants
7 participants

SECONDARY outcome

Timeframe: up to 7 days following consent

The proportion of rescue medication usage from POD 1 through POD 7 compared between the combined and the alternating medication regimens.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Number of Participants With Rescue Medication Usage Through POD 7
1 participants
0 participants

SECONDARY outcome

Timeframe: up to 3 days following consent

Proportion of subjects that adhere to the assigned medication regimen compared between the combined and the alternating medication regimens as determined by the medication log that the participants return at the end of the study.

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Proportion of Subjects That Adhere to the Assigned Medication Regimen
25 Participants
25 Participants

SECONDARY outcome

Timeframe: up to 7 days following consent

Population: Alternating regimen

Incidence of adverse events

Outcome measures

Outcome measures
Measure
Alternating Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 Participants
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Adverse Events
3 participants
3 participants

Adverse Events

Alternating Regimen

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Combined Regimen

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Alternating Regimen
n=25 participants at risk
A regimen of acetaminophen and ibuprofen alternating doses every 3 hours. Alternating Acetaminophen and Ibuprofen: Subjects will alternate their post-operative acetaminophen and ibuprofen every 3 hours.
Combined Regimen
n=25 participants at risk
A regimen of acetaminophen and ibuprofen dosed together every 6 hours. Combined Acetaminophen and Ibuprofen: Subjects will take their post-operative acetaminophen and ibuprofen together every 6 hours.
Gastrointestinal disorders
Nausea
8.0%
2/25 • Number of events 2 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.
4.0%
1/25 • Number of events 1 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.
Gastrointestinal disorders
Emesis
12.0%
3/25 • Number of events 3 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.
4.0%
1/25 • Number of events 1 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.
Gastrointestinal disorders
Bloody Oral Secretions
0.00%
0/25 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.
4.0%
1/25 • Number of events 1 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.
General disorders
Pain - Uncontrolled
4.0%
1/25 • Number of events 1 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.
4.0%
1/25 • Number of events 1 • Adverse event data was collected post operatively days 1 through 7
Follow up surveys to assess pain scores and adverse events were sent to participants twice a day on post-operative day (POD) 1, 3, and 7.

Additional Information

David Leonard, MD, Principal Investigator

Washington University School of Medicine

Phone: 314-454-2136

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place