Monday, October 12, 2009

Tylenol With Codeine Better For Broken Arms? (click here)

Children treated for arm fractures with ibuprofen had their pain reduced just as effectively as a combination of acetaminophen and codeine (Tylenol 3), with fewer adverse effects, in a randomized, double-blind trial.

The study tested ibuprofen, sold as Advil, Motrin and other brands, against acetaminophen plus codeine — a combo called Tylenol No. 3 that is also sold in generic form.

"The children on ibuprofen did better," said the study leader, Dr. Amy Drendel of the Medical College of Wisconsin in suburban Milwaukee. "They were more likely to play, they ate better and they had fewer adverse effects," she said.

Among those kids taking ibuprofen, 29.5% reported an adverse effect. Among those taking the codeine-laced drug, 50.9% reported an adverse effect. Such reactions included nausea, vomiting, drowsiness, dizziness and constipation.

The results do not mean that ibuprofen beats acetaminophen for everyday pain relief in children or anyone else.

The study tested a specific use — pain in the first three days after a broken arm — and the acetaminophen was combined with the narcotic codeine, not tested alone.

Broken arms are one of the most common childhood injuries, with one study estimating that 18 percent of children will have a fracture some time during the first nine years of life.

Researchers randomly assigned 336 children ages 4 to 18 to go home with liquid versions of either ibuprofen or the acetaminophen-codeine combo after being treated for a broken arm at Children's Hospital of Wisconsin. Neither the children, parents nor the doctors knew who received what treatment until the study ended.

“It’s tough enough as a child to have a broken arm without also having to deal with pain,” said Dr. Drendel. “It’s good for both emergency physicians and parents to have pain-management options that can help get a child back to playing as quickly as possible.”

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