Hannam JA, et al. - Researchers ascertained the effect of tramadol in children given acetaminophen-ibuprofen combination therapy for acute pain management, assuming that a model describing the interaction between these three drugs would be useful to understand the role of supplemental analgesic therapy. Participants were children who were administered oral paracetamol and ibuprofen perioperatively while undergoing tonsillectomy. According to findings, ibuprofen had an EC₅₀ for analgesia in children similar to that of adults (3.95 mg/L; 95%CI 2.57-7.53, vs 5-10 mg/L adults). Commonly used doses of combination therapy offered satisfactory analgesia at the maximum effect (ie, 65% reduction in pain score) but increased dose added little additional benefit. A prolonged analgesia duration was achieved with the addition of tramadol to this analgesic mixture.