Effects of intraoperative i.v. acetaminophen vs i.m. meperidine on post-tonsillectomy pain in children

Alhashemi, Jamal A.; Daghistani, Mustafa

doi:10.1093/bja/ael084

Cited by 87 publications

(71 citation statements)

References 20 publications

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“…Although multiple studies [18][19][20] have shown an opioid-sparing effect or enhanced analgesic efficacy of intravenous acetaminophen in the adult and pediatric population for various surgical procedures, a similar effect was not seen in our study cohort. One explanation is that our usual analgesic regimen for such patients included an intraoperative dose of morphine (0.1 mg/kg), which was adequate for many of the patients, thereby mitigating the ability to see any additional effect from a single intraoperative dose of a non-opioid analgesic.…”

Section: Discussioncontrasting

confidence: 69%

Double-Blind Randomized Placebo-Controlled Trial of Single-Dose Intravenous Acetaminophen for Pain Associated With Adenotonsillectomy in Pediatric Patients With Sleep-Disordered Breathing

Thung

Elmaraghy

Barry

et al. 2017

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVES Adequate pain control is an important component in the postoperative outcome for pediatric adenotonsillectomy patients with sleep-disordered breathing (SDB). Intravenous acetaminophen appears to be a favorable analgesic adjunct owing to its predictable pharmacokinetics and opioid-sparing effects; however, its role in pediatric adenotonsillectomy pain management remains unclear. METHODSIn this prospective, randomized, double-blinded, controlled study, subjects with the diagnosis of SDB, aged 2 to 8 years, who required extended postoperative admission, received intravenous acetaminophen (15 mg/kg) or saline placebo intraoperatively in addition to morphine (0.1 mg/kg) for postoperative surgical analgesia. Pain scores in the postanesthesia care unit (PACU) using the FLACC (Faces, Leg, Activity, Cry, Consolability) score were used to determine the need for supplemental analgesic agents in the PACU. The PACU time and time to the first request for pain medication on the inpatient ward were also measured.

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Section: Discussioncontrasting

confidence: 69%

Double-Blind Randomized Placebo-Controlled Trial of Single-Dose Intravenous Acetaminophen for Pain Associated With Adenotonsillectomy in Pediatric Patients With Sleep-Disordered Breathing

Thung

Elmaraghy

Barry

et al. 2017

The Journal of Pediatric Pharmacology and Therapeutics

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“…[19,20] A systematic meta-analysis has revealed that IV acetaminophen reduces nausea when prophylactically administered either before surgery or before arrival in the post-anesthesia care unit; but not when administered after the onset of pain. [15] Consistent with these results; the incidence of nausea and vomiting during the first 0-6 h postoperatively was found to be lower in patients who received preoperative paracetamol than in those who received postoperative paracetamol in our study.…”

Section: Discussionmentioning

confidence: 99%

The effect of intravenous preoperative versus postoperative paracetamol on postoperative nausea and vomiting in patients undergoing strabismus surgery: A prospective randomised study

Aksoy

İnce²,

Ahişkalıoğlu³

et al. 2018

Agri

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SummaryObjectives: This prospective randomized study aimed to compare the efficacy of preoperative versus postoperative paracetamol on postoperative nausea and vomiting (PONV) in children undergoing strabismus surgery. Methods: Ninety-six patients were randomly divided into three equal groups (n=32). In the preoperative paracetamol group, patients received intravenous (IV) infusion of paracetamol [15 mg kg −1 (1.5 ml kg)] 1 h before surgery over 20 min and that of saline (1.5 ml kg −1 ) in the recovery room. In the postoperative paracetamol group, patients received IV infusion of saline (1.5 ml kg )] in therecovery room. In the control group, patients received the IV infusion of saline (1.5 ml kg −1 ) pre-and postoperatively. Postoperative pain condition was evaluated using the Faces Pain Scale. In the recovery room, an observer recorded the pain score, complaints of nausea and vomiting, the need for rescue analgesics, and the need for antiemetic drug during 24 h postoperatively. Results: The incidence of nausea and vomiting during the first 0-6 h postoperatively was significantly lower in the preoperative paracetamol group than in the control and postoperative paracetamol groups (p<0.001). The number of patients requiring antiemetic administration during the first 0-6 and 6-12 h postoperatively was found to be higher in the control group than in the other groups (p<0.001, for all). Conclusion:The preoperative administration of paracetamol reduces PONV incidence in children undergoing strabismus surgery.

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“…The Objective Pain Scale is a validated tool that has been extensively used to compare different analgesic modalities in children (Table 1). 11 In addition, on Day 1 and Day 5, the child completed a modified Faces Scale, a validated tool (ages 1-14 years), which is also commonly used for pain measurement after adenotonsillectomy. 12 Parents were trained by the research staff on how to complete both pain scales.…”

Section: After Approval By Mcmastermentioning

confidence: 99%

Morphine or Ibuprofen for Post-Tonsillectomy Analgesia: A Randomized Trial

et al. 2015

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Effects of intraoperative i.v. acetaminophen vs i.m. meperidine on post-tonsillectomy pain in children

Abstract: Compared with i.m. meperidine, i.v. acetaminophen provided adequate analgesia, less sedation and earlier readiness for recovery room discharge among paediatric patients undergoing tonsillectomy.

Cited by 87 publications

References 20 publications

Double-Blind Randomized Placebo-Controlled Trial of Single-Dose Intravenous Acetaminophen for Pain Associated With Adenotonsillectomy in Pediatric Patients With Sleep-Disordered Breathing

Double-Blind Randomized Placebo-Controlled Trial of Single-Dose Intravenous Acetaminophen for Pain Associated With Adenotonsillectomy in Pediatric Patients With Sleep-Disordered Breathing

The effect of intravenous preoperative versus postoperative paracetamol on postoperative nausea and vomiting in patients undergoing strabismus surgery: A prospective randomised study

Morphine or Ibuprofen for Post-Tonsillectomy Analgesia: A Randomized Trial

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