Comparing the Duration of the Analgesic Effects of Intravenous and Rectal Acetaminophen Following Tonsillectomy in Children

Abstract

Background:Postoperative pain control (especially, after adenotonsillectomy) has a very important effect on recovery time, hospitalization duration, hemodynamic disorders, bleeding, nausea, vomiting and medical costs.Objectives:The aim of this study was to investigate and compare the effects of intravenous and rectal acetaminophen on controlling post-adenotonsillectomy pain in children, and duration of their analgesic effects.Patients and Methods:In this randomized double-blinded clinical trial, 96 children aged 4 - 10 years old with ASA physical status I or II who were candidates for adenotonsillectomy surgery in Amir-al-Momenin Hospital, Rasht, Iran were entered into the study and randomly divided into two equal groups. Anesthesia in both groups was induced injecting fentanyl-thiopental and at racurium; afterwards is of lurane was used to maintain anesthesia. After anesthesia induction, one group received intravenous and the other one, rectal acetaminophen, and were later compared based on CHIPPS criteria.Results:Data analysis indicated a significant relationship between reduction of postoperative pain and the use of intravenous or rectal acetaminophen (P = 0.0001); in group receiving IV acetaminophen, only 10.4% of patients had no pain whereas in group receiving rectal acetaminophen, this number reached 43.8%. Also, on 4 and 6 hour time intervals, pain in rectal acetaminophen receiving group was less than that in IV acetaminophen receiving group (P < 0.05). Demand for additional analgesic medication in rectal acetaminophen receiving group was less than that in IV group (P = 0.0001).Conclusions:Post-operative pain in rectal acetaminophen group was less than that in intravenous acetaminophen group, and rectal acetaminophen group demanded their first additional analgesic medication later.

Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and meta‐analysis

“…The opioid medications are widely used as the main strategy for perioperative pain control, however, associated with side effects like respiratory depression, leading to sedation and respiratory depression, and postoperative nausea and vomiting. In response to this, Non‐opioid analgesic strategies including non‐steroidal anti‐inflammatory drugs, local anesthetic infiltration, antibiotics nonvolatile induction and maintenance, alpha‐2 agonists, homeopathic drugs, caudal block, and delay of the emergence period have been studied to evaluate the effect on decreasing these complications but the results are not reliably helpful .…”

The randomised prospective comparative study to see the duration of analgesia following intravenous or rectal acetaminophen after adenotonsillectomy in children

“…Result showed rectal acetaminophen was superior. 13 Though in this study, at 4 hours interval pain scores were comparable but at 6 hours pain score was significantly more in I.V. group and required rescue analgesia.…”

“…and rectal acetaminophen in pediatric patients after adenoidectomy. 13 On 4-and 6hours intervals the pain in rectal acetaminophen group was less than in I.V. acetaminophen group.…”

“…paracetamol. [13][14][15] Similarly, Mahajan et al, also observed that duration of analgesia in post cesarian patients who received rectal acetaminophen was much longer than those who received I.V. paracetamol.…”

The Effect of Postoperative Single-Dose Intravenous Dexamethasone on Common Complications After Tonsillectomy in Children: A Randomized Controlled Trial

“…Common complications of tonsillectomy are postoperative pain, nausea and vomiting, bleeding, delayed feeding, voice change, and rarely, death (2)(3)(4). It has been stated that effective management of postoperative pain can prevent morbidity, facilitate early oral intake, and decrease the risk of bleeding (5)(6)(7). Nonsteroidal anti-inflammatory drugs (NSAIDs) have been administrated for their analgesic effects.…”