Comparison of oral versus rectal administration of acetaminophen with codeine in postoperative pediatric adenotonsillectomy patients

Laryngoscope. 2006 Aug;116(8):1485-8. doi: 10.1097/01.mlg.0000227530.64179.1f.


Objective: To examine whether acetaminophen with codeine administered per rectum is an effective alternative for pain control compared with oral administration after an adenotonsillectomy.

Study design: A prospective, randomized control study.

Methods: Seventy-five children aged 1 to 5 were recruited for this study. Each child was assigned randomly to receive either rectal or oral postoperative pain medication. A journal with eight questions was kept for 10 days after the operation, and an overall survey of five questions was filled out at the first postoperative visit.

Results: Postoperative pain was adequately controlled in those patients receiving suppositories when compared with those patients receiving oral pain medication. Adverse effects and total number of doses given per day were similar. Parents found the suppositories easy to administer, and more parents would switch or consider switching from oral pain medication to suppositories if given the choice.

Conclusions: The suppositories achieved equivalent pain control as oral medication with few side effects and good tolerance. Furthermore, many parents preferred the suppositories to oral medication in maintaining postoperative pain control because of ease of administration. If given the choice for future surgeries, many parents would switch or consider switching from oral pain medication to suppositories.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / administration & dosage*
  • Acetaminophen / adverse effects
  • Adenoidectomy*
  • Administration, Oral
  • Administration, Rectal
  • Child, Preschool
  • Codeine / administration & dosage*
  • Codeine / adverse effects
  • Female
  • Humans
  • Infant
  • Male
  • Medical Records
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Suppositories
  • Tonsillectomy*


  • Suppositories
  • Acetaminophen
  • Codeine