Analgesic efficacy of rectal versus oral acetaminophen in children after major craniofacial surgery

Marel, C. D. van der; Lingen, Richard A. van; Pluim, M. A. L.; Scoones, Gail P.; Dijk, Monique van; Vaandrager, J. Michiel; Tibboel, Dick

doi:10.1067/mcp.2001.116794

Cited by 65 publications

(45 citation statements)

References 20 publications

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“…There was a divergence between the conclusions of the two RCTs found on the first comparison; one appointed an effective pain control and equivalence in regards to nauseas and vomits (rectal loading dose of 40 mg/kg followed by 30 mg/kg 8 hourly) [36], whereas the other one did not observe effective pain control (single prophylactic dose of 40 mg/kg) [37], emphasizing the fact that both analyzed palatoplasties. These results are in concordance with the standard clinical practice that states a postoperative rectal loading dose (30–40 mg/kg) followed by regular maintenance doses (20 mg/kg 6 hourly or 30 mg/kg 8 hourly) [68–70]. Besides the difficulties associated with rectal administration (e.g., delayed and erratic absorption), an RCT done in patients undergoing craniosynostosis repair verified a higher efficacy than oral administration [68].…”

Section: Discussionsupporting

confidence: 83%

Protocols in Cleft Lip and Palate Treatment: Systematic Review

Ladeira

Alonso

2012

Plastic Surgery International

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Objectives. To find clinical decisions on cleft treatment based on randomized controlled trials (RCTs). Method. Searches were made in PubMed, Embase, and Cochrane Library on cleft lip and/or palate. From the 170 articles found in the searches, 28 were considered adequate to guide clinical practice. Results. A scarce number of RCTs were found approaching cleft treatment. The experimental clinical approaches analyzed in the 28 articles were infant orthopedics, rectal acetaminophen, palatal block with bupivacaine, infraorbital nerve block with bupivacaine, osteogenesis distraction, intravenous dexamethasone sodium phosphate, and alveoloplasty with bone morphogenetic protein-2 (BMP-2). Conclusions. Few randomized controlled trials were found approaching cleft treatment, and fewer related to surgical repair of this deformity. So there is a need for more multicenter collaborations, mainly on surgical area, to reduce the variety of treatment modalities and to ensure that the cleft patient receives an evidence-based clinical practice.

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Section: Discussionsupporting

confidence: 83%

Protocols in Cleft Lip and Palate Treatment: Systematic Review

Ladeira

Alonso

2012

Plastic Surgery International

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“…15 Moreover, some evidence revealed that antipyretic serum concentration of 15-20 µg/mL could not be achieved by rectal dose of 10-15 mg/kg and a rectal dose of 30-45 mg/kg was needed. [15][16][17][18][19] In some circumstances, rectal preparation is used, such as when the patient is vomiting or the physician or parents prefer the rectal route. 20 By a computer-generated random table, subjects were assigned to one of two groups.…”

Section: Introductionmentioning

confidence: 99%

Comparação da eficácia de doses iguais de acetaminofeno retal e oral em crianças

Karbasi¹,

Modares-Mosadegh²,

Golestan³

2010

J. Pediatr. (Rio J.)

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Objective: To compare a dose of oral and rectal acetaminophen and to evaluate acceptability of rectal acetaminophen, since oral and rectal acetaminophen is widely used as an antipyretic agent in febrile children and the comparative effectiveness of these two preparations is not well established. Methods:In this prospective parallel group designed study, 60 children who presented to the emergency department or outpatient pediatric clinic at a tertiary hospital and aged from 6 months to 6 years with rectal temperature over 39 °C were enrolled. Patients were randomly assigned to two equal-sized groups. Group 1 received 15 mg/kg acetaminophen rectally and group 2 received the same dose orally. Temperature was recorded at baseline and 1 and 3 hours after drug administration. Results:In the first group, mean decrease in temperature, 1 and 3 hours after administration of acetaminophen was 1.07±0.16 (p < 0.001) and 1.74±0.25 °C (p < 0.001), respectively, and in the second group it was 1.98±0.19 (p < 0.001) and 1.70±0.14 °C (p < 0.001), respectively (p > 0.05). Conclusion:Rectal and oral acetaminophen preparations have equal antipyretic effectiveness in children. The rectal route proved to be as acceptable as the oral one among parents. J Pediatr (Rio J). 2010;86(3):228-232:Oral acetaminophen, rectal acetaminophen, fever.

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“…Assessment of effect in neonates is difficult, and attempts to show concentrationresponse relations have been unfruitful, 12 as in the present study. Assessment tools may measure discomfort rather than pain, neonatal wind up may exist, pain is not constant, placebo effects contribute, and large interindividual variability has been reported for pharmacodynamic parameter estimates.…”

mentioning

confidence: 90%

Disentangling PK-PD in neonates

Anderson

2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Analgesic efficacy of rectal versus oral acetaminophen in children after major craniofacial surgery

Cited by 65 publications

References 20 publications

Protocols in Cleft Lip and Palate Treatment: Systematic Review

Protocols in Cleft Lip and Palate Treatment: Systematic Review

Comparação da eficácia de doses iguais de acetaminofeno retal e oral em crianças

Disentangling PK-PD in neonates

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