Pharmacokinetics of oral diclofenac and acetaminophen in children after surgery

Rømsing, Janne; Østergaard, Doris; Senderovitz, Thomas; Drozdziewicz, Dominika; Sonne, Jesper; Ravn, Grete

doi:10.1046/j.1460-9592.2001.00660.x

Cited by 47 publications

(43 citation statements)

References 17 publications

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“…The absorption half-life for the oral preparation is believed to be 4.5 min without a detectable lag time. 15 Overall, 43% of children required acetaminophen postoperatively and this was distributed equally amongst the three groups. Acetaminophen use in PARR and in SDCU demonstrates that the incidence of postoperative pain requiring treatment is low in our population and equally distributed in all three groups.…”

Section: Objectifmentioning

confidence: 93%

Amethocaine or ketorolac eyedrops provide inadequate analgesia in pediatric strabismus surgery

Kim

Azavedo

Bhananker

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Corrective strabismus surgery is associated with moderate pain after surgery. Postoperative analgesia for these patients may include topical local anesthetic agents and topical non-steroidal antiinflammatory drugs. In this prospective randomized, double-blind placebo controlled clinical trial we compared the effect of placebo to intraoperative 0.5% topical amethocaine or 0.5% topical ketorolac on pain control after strabismus surgery in children.

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Section: Objectifmentioning

confidence: 93%

Amethocaine or ketorolac eyedrops provide inadequate analgesia in pediatric strabismus surgery

Kim

Azavedo

Bhananker

et al. 2003

Can J Anesth/J Can Anesth

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“…Bei Untersuchungen zur Anwendung in der postoperativen Schmerztherapie bei Kindern resultierte wiederholt eine verlän-gerte T max (1,4 bzw. 1,6 h), die auf die postoperativ verzögerte Magenentleerung und dadurch beeinträchtigte Absorption zurückgeführt wird [30,78]. können die Resorptionskinetik beeinflussen (Tabelle 1).…”

Section: Orale Gabeunclassified

“…Maximale Plasmakonzentrationen (C max ) nach rektaler Gabe werden bei Kindern nach 1,3-4,8 h erreicht [6,20,30,33,37,38,42,48,54,61,78].…”

Section: Orale Gabeunclassified

“…Im direkten Vergleich mit NSAID's (Diclofenac) bzw. Opioiden (Tramadol) war die analgetische Effektivität von niedrig dosiertem Paracetamol (je nach Untersuchung 10-22,5 mg/ kg KG, unterschiedliche operative Eingriffe) jeweils deutlich unterlegen [63,66,78,85].…”

Section: Analgetische Wirksamkeit Von Paracetamol In Niedriger Dosierungunclassified

“…So stellte sich in einer Untersuchung nach Tonsillektomie trotz therapeutischer Plasmaspiegel keine adäquate Analgesie ein [78], wohingegen von anderen Autoren ab einem Paracetamol-Plasmaspiegel von 10 µg/ml eine deutlich verbesserte analgetische Wirkung nach dem gleichen Eingriff beobachtet wurde [8].…”

Section: Kritische Wertung Der Literatur Unter Klinischen Aspekten Zuunclassified

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Paracetamol im Kindesalter Aktueller Wissensstand und Hinweise für einen rationalen Einsatz zur postoperativen Analgesie

Mantzke¹,

Brambrink²

2002

Anaesthesist

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The administration of paracetamol (in the US known as acetaminophen) to children and infants for postoperative pain after minor surgery is a well established and safe treatment option, if appropriately used. However, if paracetamol is dosed according to traditional recommendations (about 20 mg/kg body weight) frequently a sufficient analgetic effect cannot be achieved immediately after painful interventions. Recently, a higher initial dose (40 mg/kg body weight) was suggested for effective postoperative pain control, which seems especially important for children after ambulatory anesthesia, but may also be associated with certain risks to the patient. Current recommendations also involve appropriate timing and route of administration of paracetamol to be most effective under different clinical circumstances. In contrast, the risk for liver toxicity appears to be very low, if the daily paracetamol dose does not exceed 90 mg/kg body weight in otherwise healthy children, and if specific risk factors of the individual patient are always considered. This review discusses the recent publications on pharmacokinetics and -dynamics, the clinical use and dosing, as well as the risks and benefits of paracetamol for the treatment of postoperative pain in children and infants. Based on this information, specific dosing regimes for the postoperative period are suggested for neonates and infants, as well as for children in different age groups.

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Diclofenac for acute pain in children

Standing

Savage

Pritchard

et al. 2009

Cochrane Database of Systematic Reviews

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Pharmacokinetics of oral diclofenac and acetaminophen in children after surgery

Abstract: The achieved concentrations of diclofenac and acetaminophen were not able to significantly reduce the children's pain score during the 5 h postingestion study period. Analgesic plasma acetaminophen concentrations may be higher than those required for antipyresis.

Cited by 47 publications

References 17 publications

Amethocaine or ketorolac eyedrops provide inadequate analgesia in pediatric strabismus surgery

Amethocaine or ketorolac eyedrops provide inadequate analgesia in pediatric strabismus surgery

Paracetamol im Kindesalter Aktueller Wissensstand und Hinweise für einen rationalen Einsatz zur postoperativen Analgesie

Diclofenac for acute pain in children

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