Evidence map›Paper›PMID 40396501›Full record

Trial reportOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2025

Opioid Analgesia Following Pediatric Adenotonsillectomy: A Randomized Clinical Trial.

Rachel L Whelan, Jennifer L McCoy, Leonid Mirson, Raymond C Maguire, Noel Jabbour, Jeffrey P Simons, Joseph E Dohar, Dennis J Kitsko, Amanda L Stapleton, Allison B J Tobey and 4 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03618823 (Randomized Clinical Trial of Non-Opioid Pain Medications After Adenotonsillectomy), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03618823 phase1 / phase2terminatednot on this map

Randomized Clinical Trial of Non-Opioid Pain Medications After Adenotonsillectomy

TypeinterventionalSponsorDavid Chi, MDRan2018 to 2020Enrolled268ConditionsAdenotonsillectomy, Post-operative Analgesia, Opioid UseArmsOxycodone, Ibuprofen, Acetaminophen
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Safety Assessment of Perioperative Pain Medications for Children: Variation in Opioid Prescribing at Discharge.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Rachel L WhelanUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Jennifer L McCoyUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Leonid MirsonUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Raymond C MaguireUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Noel JabbourUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Jeffrey P SimonsUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Joseph E DoharUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Dennis J KitskoUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Amanda L StapletonUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Allison B J TobeyUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Cuneyt M AlperUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
Amber D ShafferUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.ORCID http://orcid.org/0000-0001-5783-9198
Zachary R BennettUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
David H ChiUPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the safety and efficacy of nonopioid versus opioid pain management following adenotonsillectomy (AT) among pediatric patients. STUDY

designAn open-label randomized controlled trial.

settingTertiary care children's hospital.

methodsPatients aged 3 to 17 years undergoing AT were eligible. Participants were randomly assigned to receive either acetaminophen and ibuprofen (nonopioid group) or acetaminophen, ibuprofen, and oxycodone (opioid group). Pain scores and prevalence of emergency department (ED) visits, hospital readmission, and posttonsillectomy hemorrhage (PTH) were compared between groups.

resultsFrom January 2019 to March 2020, 267 patients were enrolled and randomly assigned; 144 completed a postoperative pain diary. Of the 144, 69 (48%) patients received an opioid prescription, and 75 (52%) did not. Mean pain scores before (opioid: 5.78, 95% CI: 5.29-6.27 vs nonopioid: 5.66, 95% CI: 5.20-6.12) and after (opioid: 2.33, 95% CI: 1.89-2.78 vs nonopioid: 2.24, 95% CI: 1.82-2.66) analgesics were not significantly different between opioid and nonopioid groups. Although 7/75 (9%) from the nonopioid group crossed over and requested opioids, only 43/69 (62%) randomly assigned to receive opioid prescription consumed opioids. The rate of opioid consumption increased with increasing age: 18/71 (25%) patients aged 3 to 7 years, 22/57 (39%) 8 to 12 years, and 10/16 (63%) 13 to 17 years, P = .015. Differences in ED visits, hospital readmissions, and PTH between opioid and nonopioid groups were not significant.

conclusionMany children do not require opioid analgesics following AT, particularly children less than 8 years of age. Postoperative pain scores and outcomes were similar in opioid versus nonopioid groups. Opioid prescriptions should be limited or avoided altogether after pediatric AT.

trial registrationTitle: Nonopioids for analgesia after adenotonsillectomy in children; ID: NCT03618823, Clinicaltrials.gov.

Indexed as

AdenoidectomyAnalgesics, Non-NarcoticAnalgesics, OpioidPain ManagementPostoperative PainTonsillectomyAcetaminophenAdolescentChildChild, PreschoolFemaleHumansIbuprofenMaleOxycodonePain MeasurementAcetaminophenAnalgesics, Non-NarcoticAnalgesics, OpioidIbuprofenOxycodoneopioid prescriptionpediatric opioidpostoperative opioidpostoperative paintonsillectomy pain

Identifiers

PMID40396501
PMCPMC12312295

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.