Comparing The Efficacy of Ibuprofen alone with Ibuprofen and Paracetamol in Combination in Relieving Post Tonsillectomy Pain in Children: A Prospective Comparative Study

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Saqib Aziz
Noshad Ali
Muhammad Ilyas
Saba Rehman
Saeed Khan
Deepak Rai


Background: Tonsillectomy is a frequent surgical intervention for recurrent tonsillitis in both adults and children, employing predominantly the cold steel method. Pain management post-surgery primarily involves NSAIDs and opioids, with varying degrees of effectiveness and side effects.

Objective: The study aimed to evaluate the pain relief efficacy of combining ibuprofen with paracetamol compared to the use of ibuprofen alone in children post-tonsillectomy.

Methods: Following ethical approval, 278 children with recurrent sore throat and quinsy were enrolled in an inpatient study at the Department of ENT, A unit of Hayatabad Medical Complex, Peshawar, from May 06 to August 30, 2023. This analytic cross-sectional study utilized a comparative prospective data collection approach and non-probability convenience sampling. Participants included 142 boys and 136 girls, aged 6 to 12 years.

Results: Of the total 278 children, 142 (51.1%) were male and 136 (48.9%) female. Ibuprofen alone was prescribed to 136 children, while 134 received a combination of ibuprofen and paracetamol. Among those treated with the combination therapy, 65 (23.4%) reported no pain (VAS scores 1-3). In contrast, those receiving ibuprofen alone reported moderate pain (VAS scores 4-7) as follows: 2.2% (N=6), 11.2% (N=31), 19.4% (N=54), and 9.4% (N=26); and severe pain (VAS scores 8-10) was reported by 6.5% (N=18) and 0.4% (N=1).

Conclusion: The combination of ibuprofen and paracetamol is significantly more effective in managing post-tonsillectomy pain in children compared to ibuprofen alone.

Article Details

How to Cite
Aziz, S., Ali, N., Ilyas, M., Rehman, S., Khan, S., & Rai, D. (2024). Comparing The Efficacy of Ibuprofen alone with Ibuprofen and Paracetamol in Combination in Relieving Post Tonsillectomy Pain in Children: A Prospective Comparative Study. Journal of Health and Rehabilitation Research, 4(1), 1243–1247.
Author Biographies

Saqib Aziz, Shaukat Khanum Hospital Lahore.

Fellow Head and Neck Surgical Oncology, Shaukat Khanum Hospital, Lahore.

Noshad Ali, Jinnah Postgraduate Medical Centre Karachi.

Postgraduate Trainee, Department of ENT, Jinnah Postgraduate Medical Centre Karachi.

Muhammad Ilyas, PGMI/AMC/LGH Lahore

Associate Professor, Department of ENT, PGMI/AMC/LGH Lahore

Saba Rehman, RMI Peshawar.

Medical Officer, Paeds Department, RMI Peshawar.

Saeed Khan, Hayatabad Medical Complex/KGMC Peshawar

Assistant Professor, Department of ENT & Head and Neck, Hayatabad Medical Complex/KGMC, Peshawar

Deepak Rai, JPMC Karachi

Post Graduate Trainee, FCPS, Department of ENT, JPMC Karachi


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