For a broken arm, give a child ibuprofen -- not codeine, researchers say

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The parent of a kid with a newly broken arm -- not to mention the kid himself or herself -- is unlikely to want to leave the emergency department without a prescription for pain relief. A new study suggests that such relief should come from ibuprofen.

Researchers at the Medical College of Wisconsin studied 336 children, ages 4 to 18, with arm fractures, half of whom were prescribed ibuprofen upon their discharge from the emergency department, half of whom were given acetaminopen with codeine. The patients and their family then kept a diary of pain and medication side effects for the next 72 hours.

Not only did the ibuprofen work just fine in controlling pain -- at least as good as the codeine-laced acetaminophen -- the medicine normally associated with relieving headaches and muscle aches also had far fewer downsides.

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

As for pain and its ability to affect general function, the kids taking ibuprofen were less likely to report effects on their play and eating.

That’s not to say side effects can’t happen with any drug. Here’s information from drugs.com on the medications used in this study -- ibuprofen suspension and acetaminophen with codeine suspension.

The researchers point out that some doctors might not be particularly enamored of the idea of recommending nonsteroidal anti-inflammatory drugs (or NSAIDs), of which ibuprofen is one, for kids who have broken a bone, even if the break is just a fracture. Animal studies have suggested that NSAIDS may negatively affect the way the bone heals.

But considering the lack of research on that possibility -- and the clear findings of this study -- the findings to them seem clear. They conclude: ‘Ibuprofen is preferable to acetaminophen with codeine for outpatient treatment of children with uncomplicated arm fractures.’

The study was published today in the Annals of Emergency Medicine.

-- Tami Dennis