PMID- 36053661
OWN - NLM
STAT- MEDLINE
DCOM- 20220908
LR  - 20220910
IS  - 2399-9772 (Electronic)
IS  - 2399-9772 (Linking)
VI  - 6
IP  - 1
DP  - 2022 May
TI  - Quantifying the intensity of adverse events with ibuprofen and oxycodone: an 
      observational cohort study.
LID - 10.1136/bmjpo-2022-001428 [doi]
LID - e001428
AB  - OBJECTIVE: To quantify the frequency and intensity of adverse events (AEs), 
      commonly known as side effects, experienced by children receiving either 
      ibuprofen or oxycodone for pain management following an acute fracture. Secondary 
      objectives were to quantify functional outcome impairment and describe 
      demographic and clinical characteristics associated with AEs. DESIGN: 
      Observational cohort study. SETTING: Paediatric emergency department. PATIENTS: 
      Patients (n=240) aged 4-16 years diagnosed with an acute fracture. INTERVENTION: 
      Prescribed either ibuprofen (n=179) or oxycodone (n=61) for pain. MAIN OUTCOME 
      MEASURES: Families were called for the first 3 days after discharge to report the 
      presence and intensity of AEs and their child's functional outcomes (ability to 
      eat, sleep, play or attend school). RESULTS: On day 1, children using oxycodone 
      were more likely to report any AE (chi(2) (1)=13.5, p<0.001), nausea (chi(2) 
      (1)=17.0, p<0.001), vomiting (chi(2) (1)=11.2, p<0.001), drowsiness (chi(2) 
      (1)=13.7,p<0.001), constipation (chi(2) (1)=8.9, p=0.003) and dizziness (chi(2) 
      (1)=19.1, p<0.001), compared with those using ibuprofen. Children receiving 
      oxycodone reported greater severity of abdominal pain (oxycodone: mean 5.4 SD 
      3.1; ibuprofen mean 2.5 SD 1.4, F(1) (13)=6.5, p=0.02) on day 1 and worse 
      intensity of constipation (oxycodone: mean 4.9 SD 2.1; ibuprofen mean 3.2 SD 2.2, 
      F(1) (33)=4.5, p=0.04) over all 3 days. Use of oxycodone was associated with an 
      increased odds of experiencing an AE on day 1 (OR=1.31 (95% CI 1.13 to 1.52)). 
      Higher pain scores (OR=1.50 (95% CI 1.12 to 2.01)), lower extremity fracture 
      (OR=1.25 (95% CI 1.07 to 1.47)) and undergoing ED sedation (OR=1.16 (95% CI 1.01 
      to 1.34)) were associated with missing school. Higher pain scores (OR=1.50 (95% 
      CI 1.14 to 1.97)) and lower extremity fractures (OR=1.23 (95% CI 1.07 to 1.43)) 
      were also associated with less play. CONCLUSIONS: Oxycodone is associated with 
      more frequent AEs overall, higher intensity gastrointestinal AEs and greater 
      functional limitations compared with ibuprofen. Lower extremity fractures cause 
      more functional limitations than upper extremity fractures. Clinicians should 
      consider these differences when providing fracture pain care for children.
CI  - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Ali, Samina
AU  - Ali S
AUID- ORCID: 0000-0002-0595-364X
AD  - Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada 
      sali@ualberta.ca.
AD  - Women and Children's Health Research Institute, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Gourlay, Katie
AU  - Gourlay K
AD  - Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, 
      Canada.
FAU - Yukseloglu, Aran
AU  - Yukseloglu A
AD  - Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
FAU - Rosychuk, Rhonda J
AU  - Rosychuk RJ
AD  - Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
AD  - Women and Children's Health Research Institute, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Ortiz, Silvia
AU  - Ortiz S
AD  - Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
FAU - Watts, Rick
AU  - Watts R
AD  - Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
AD  - Women and Children's Health Research Institute, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Johnson, David W
AU  - Johnson DW
AD  - Department of Pediatrics, University of Calgary Cumming School of Medicine, 
      Calgary, Alberta, Canada.
FAU - Carleton, Bruce
AU  - Carleton B
AD  - Division of Translational Therapeutics, The University of British Columbia, 
      Vancouver, British Columbia, Canada.
FAU - Le May, Sylvie
AU  - Le May S
AD  - Faculty of Nursing, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Drendel, Amy L
AU  - Drendel AL
AD  - Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20220524
PL  - England
TA  - BMJ Paediatr Open
JT  - BMJ paediatrics open
JID - 101715309
RN  - 0 (Analgesics, Opioid)
RN  - CD35PMG570 (Oxycodone)
RN  - WK2XYI10QM (Ibuprofen)
SB  - IM
MH  - Analgesics, Opioid/adverse effects
MH  - Child
MH  - Cohort Studies
MH  - Constipation/chemically induced
MH  - Double-Blind Method
MH  - *Fractures, Bone/chemically induced
MH  - Humans
MH  - Ibuprofen/adverse effects
MH  - *Oxycodone/adverse effects
MH  - Pain/drug therapy
MH  - Pain Measurement/adverse effects
PMC - PMC9131055
OTO - NOTNLM
OT  - Analgesia
OT  - Pain
OT  - Therapeutics
COIS- Competing interests: None declared.
EDAT- 2022/09/03 06:00
MHDA- 2022/09/09 06:00
PMCR- 2022/05/23
CRDT- 2022/09/02 11:54
PHST- 2022/01/25 00:00 [received]
PHST- 2022/04/19 00:00 [accepted]
PHST- 2022/09/02 11:54 [entrez]
PHST- 2022/09/03 06:00 [pubmed]
PHST- 2022/09/09 06:00 [medline]
PHST- 2022/05/23 00:00 [pmc-release]
AID - 10.1136/bmjpo-2022-001428 [pii]
AID - bmjpo-2022-001428 [pii]
AID - 10.1136/bmjpo-2022-001428 [doi]
PST - ppublish
SO  - BMJ Paediatr Open. 2022 May;6(1):e001428. doi: 10.1136/bmjpo-2022-001428. Epub 
      2022 May 24.