Childrens

Introduction: Post-operative pain control in pediatric patients is often difficult to assess. Children often cannot verbalize their level of pain control. Pain control is often accomplished with various combinations of Tylenol, Ibuprofen, and Narcotics. Narcotic medications are commonly prescribed but have a variety of complications. We propose that treating pediatric patients with Tylenol and Motrin combination is a safe and effective way to control pain in most pediatric otolaryngology procedures.
Methods and Materials: Study approval was obtained from the IRB 194. patients, between the ages of 6 months and - 17 years, were evaluated. Some of the procedures that were performed were adenotonsillectomy, tympanostomy tubes, tympanoplasty, sinus surgery, congenital neck masses, and thyroidectomy. Patients were all started on Tylenol and Motrin following surgery. No narcotics were prescribed unless families called stating that pain control was inadequate. Parents filled out a validated survey at their first post-operative visit to assess pain control.
Results: 140/194 patients had post-operative pain that was adequately controlled by alternating Tylenol and Motrin. 27/137 required no pain medicine at all once arriving home. Nine patients requested additional pain control these include 6 adenotonsillectomies, 2 balloon dilation, and 1 PET/Adenoidectomy.
Conclusion: Alternating Tylenol and Motrin provides adequate pain control for commonly performed surgeries in the pediatric population. It is safe to wait and prescribe narcotic medications at a later point if pain control is not adequate. By decreasing reliance on narcotic medication we can reduce rates of complications associated with narcotic use.

This first paper of The Lancet Ending Preventable Stillbirth Series reviews progress in critical areas, identified in the 2011 call to action for stillbirth prevention, to inform the integrated post 2015 maternal and newborn health agenda. Global attention to babies who die in stillbirth is rapidly expanding, from integration within the new Global Strategy for Women's, Children's, and Adolescent's Health, to country policies inspired by the Every Newborn Action Plan. Supportive new guidance and metrics including stillbirth as a core health indicator and measure of quality of care are emerging. Ensuring integration of action for prenatal health the biological foundation of life long health within the continuum of care for maternal and newborn health is becoming a key priority. Still, specific actions for stillbirths remain needed for advocacy, policy formulation, monitoring and research, including remedying the dearth of data on effective coverage of proven interventions for prenatal survival. Stronger leadership is needed globally and in countries, and institutions with a mandate to lead global efforts for mothers and their babies must assert their leadership to reduce stillbirths by promoting healthy and safe pregnancies.