Original ArticlesComparison of Regularly Scheduled Ibuprofen Versus “Pro Re Nata” for Ankle Sprains in Children Treated in the Emergency Department A Randomized Controlled TrialLim, Rodrick MD∗,†,‡; Sangha, Gurinder MD∗; Lepore, Natasha MD∗; Bartlett, Katelyn M. MD∗; Seabrook, Jamie A. PhD∗,†,‡,§,∥,¶; Rieder, Michael MD, PhD∗,†,‡Author Information From the ∗Department of Paediatrics, Western University †Children's Health Research Institute ‡Lawson Health Research Institute §School of Food and Nutritional Sciences, Brescia University College ∥Department of Epidemiology & Biostatistics, Western University ¶Human Environments Analysis Laboratory, Western University, London, Ontario, Canada. Departments of Paediatrics and Medicine, Schulich School of Medicine at the University of Western Ontario, and the Children's Health Research Institute, at the Children's Hospital at London Health Sciences Centre, London, Ontario, Canada. Disclosure: The authors declare no conflict of interest. Reprints: Rodrick Lim, MD, FRCPC, FAAP, Children's Hospital at London Health Sciences Centre, 800 Commissioners Rd E, London, ON, Canada, N6C 2V5 (e-mail: [email protected]). R.L., G.S., and M.R. conceived the initial idea, reviewed, and authored the manuscript. J.A.S. provided input for statistical design and reviewed and authored the manuscript. N.L. and K.M.B. aided in study design, patient recruitment, and review of the manuscript. Pediatric Emergency Care: December 2020 - Volume 36 - Issue 12 - p 559-563 doi: 10.1097/PEC.0000000000002282 Buy Metrics Abstract Objective We compared pain and degree of disability in patients with acute ankle sprains receiving regular scheduled ibuprofen versus pro re nata (PRN). Methods This study is a randomized single-blinded controlled trial of children aged 7 to 17 years presenting with acute ankle sprain to an emergency department. Patients were randomized to receive 10 mg/kg of ibuprofen per dose (maximum 600 mg) every 6 hours regular scheduled versus PRN. Outcome measures included a 100-mm visual analog scale pain and degree of disability at day 4. A sample size of 72 children had a power of 80% to detect a clinically meaningful difference of 20 mm between the regular and PRN group. Results We randomly assigned 99 patients to receive regular scheduled (n = 50) or PRN (n = 49) ibuprofen. Pain scores and degree of disability at day 4 showed no significant differences between groups. The rate of reported adverse effects was higher in the regular scheduled group (11.4% vs 9.5%) versus the PRN group. Conclusions Our study suggests that there is little benefit from routinely using a regular scheduled ibuprofen regimen for acute pediatric ankle sprains. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.