TY - JOUR T1 - Quantifying the intensity of adverse events with ibuprofen and oxycodone: an observational cohort study JF - BMJ Paediatrics Open JO - BMJ Paediatrics Open DO - 10.1136/bmjpo-2022-001428 VL - 6 IS - 1 SP - e001428 AU - Samina Ali AU - Katie Gourlay AU - Aran Yukseloglu AU - Rhonda J Rosychuk AU - Silvia Ortiz AU - Rick Watts AU - David W Johnson AU - Bruce Carleton AU - Sylvie Le May AU - Amy L Drendel Y1 - 2022/05/01 UR - http://bmjpaedsopen.bmj.com/content/6/1/e001428.abstract N2 - 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 (χ21=13.5, p<0.001), nausea (χ21=17.0, p<0.001), vomiting (χ21=11.2, p<0.001), drowsiness (χ21=13.7,p<0.001), constipation (χ21=8.9, p=0.003) and dizziness (χ21=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, F113=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, F133=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.Data are available on reasonable request. Data cannot be shared publicly because of consent and confidentiality reasons. Data are available from the Research Informatics Lead, Women and Children’s Health Research Institute Mr. Rick Watts (rick. watts@ualberta.ca) or the corresponding author SA (sali@ualberta.ca) for researchers who meet the criteria for access to confidential data. ER -