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Journal gives balanced look at comparative harms from analgesics given to children after surgery

Ibuprofen better choice over oral morphine for pain relief in children after minor surgery

Our Review Summary

This news release reports the outcome of a randomized controlled trial comparing the effectiveness of ibuprofen and oral morphine for managing pain in children who had received a range of minor orthopedic surgeries. No difference was found in self-reported pain for the two groups, but more adverse effects were reported for the oral morphine group. The release quotes the lead author who urges that ibuprofen should be consider to be a superior option for children in such cases.


Why This Matters

With the opioid epidemic consistently in the news over the past few years, a study that suggests an alternative to narcotics for pain is likely to garner interest. At the same time, some orthopedic surgeons have been reluctant to prescribe non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin for pain after orthopedic procedures because of concerns about their impact on bone-healing.


Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

Readers are likely aware that non-prescription strength ibuprofen is readily available at a low price. The release doesn’t mention how much oral morphine costs, however. Thus, readers can’t tell whether ibuprofen might not only save children some unpleasant side effects, but save their parents money as well.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

This news release is missing a few details about the benefits that would make it better. We learn that 80 percent of children required pain relief at home and that there was no difference in the effectiveness of the two medications.

The advantage appears to be in the reduced amount of side effects from ibuprofen compared to oral morphine. The release states:

“Pain scores for children in both the oral morphine and ibuprofen groups were similar, but the children receiving oral morphine reported more adverse effects, such as nausea, vomiting, drowsiness, dizziness and constipation.

“Morphine did not provide superior analgesia, but was associated with significantly more adverse effects, making ibuprofen a better analgesic option,” write the authors.

We’d like the release to define what “significantly more adverse affects” really means.

Harms, or adverse effects, are a central part of this study, so a numerical comparison would be useful. As it turns out, 69 percent of children given oral morphine complained of negative side effects compared to 39 percent of those taking ibuprofen, according to the study. That’s a pretty big difference. We also don’t learn exactly which negative effects were most common, which turn out to be drowsiness (48 percent of study participants) and nausea (46 percent of participants).

Does the news release adequately explain/quantify the harms of the intervention?


Side effects from the drugs were listed as nausea, vomiting, drowsiness, dizziness and constipation.

Does the news release seem to grasp the quality of the evidence?


The release explains that this was a randomized clinical trial with 154 participants, their ages, that they had a range of different minor orthopedic surgeries, and that their response to pain medication was assessed for 24 hours. That’s sufficient information for the brief format of a news release.

Does the news release commit disease-mongering?


There’s no disease mongering here. The news release clearly states that these children had minor procedures. It’s a little bit confusing that one take-away provided from the study is that more study needs to be done about management of severe pain, but overall the case is stated matter-of-factly.

Does the news release identify funding sources & disclose conflicts of interest?


On EurekAlert!, where the release is hosted, it’s noted that the research was funded by Western University. We encourage news releases to include funders in the body of the release as well. The original study reports no conflict of interest.

Does the news release compare the new approach with existing alternatives?


This news release reports the results of a randomized superiority trial designed to specifically compare two alternatives. So the release scores well on this criterion.

Does the news release establish the availability of the treatment/test/product/procedure?

Not Applicable

Just like with cost, we don’t get information about how available oral morphine is. However, it seems safe to assume it’s widely available with a prescription.

Does the news release establish the true novelty of the approach?

Not Satisfactory

We feel a little bit misled by this news release. This isn’t the first study to demonstrate that ibuprofen can be equally as effective as morphine for mild to moderate pain by a long shot. It’s not even the first to show an equal effect in children with orthopedic issues receiving care at home. The news release should have made clear why exactly this study is news.

Total Score: 6 of 9 Satisfactory


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