The analgesic efficacy of an injectable prodrug of acetaminophen in children after orthopaedic surgery

Granry, J.C.; Rod, B.; Monrigal, J.P.; Merckx, Jacques; Bernière, J; Jean, N; Boccard, E.

doi:10.1046/j.1460-9592.1997.d01-121.x

Cited by 63 publications

(28 citation statements)

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“…17 In children, acetaminophen provided signifi cantly greater analgesic effect than placebo, after orthopedic surgery. 18 Aubrun et al 19 studied effects of ketoprofen after scoliosis surgery and observed reduced morphine requirements and better analgesia in adults who had received ketoprofen in addition to acetaminophen, compared with acetaminophen alone.…”

Section: Discussionmentioning

confidence: 99%

Acetaminophen Improves Analgesia but Does Not Reduce Opioid Requirement After Major Spine Surgery in Children and Adolescents

Hiller

Helenius²,

Nurmi³

et al. 2012

Spine

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Section: Discussionmentioning

confidence: 99%

Acetaminophen Improves Analgesia but Does Not Reduce Opioid Requirement After Major Spine Surgery in Children and Adolescents

Hiller

Helenius²,

Nurmi³

et al. 2012

Spine

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“…Nach rascher Hydrolyse wird Paracetamol freigesetzt. Ein Gramm Propacetamol setzt dabei 0,5 g Paracetamol frei [36]. Es empfiehlt sich die Verabreichung mittels Kurzinfusion; eine kontinuierliche Verabreichung ist aufgrund der Instabilität der Lösung nicht möglich.…”

Section: Intravenöse Gabeunclassified

“…So wurde in einer Untersuchung zu Propacetamol bei Kindern der maximale antipyretische Effekt 2 h nach intravenöser Applikation beobachtet [35]. In einer anderen Untersuchung zeigte sich erst eine Stunde nach Applikation ein signifikanter Unterschied bezüglich der analgetischen Wirkung im Vergleich zu Placebo [36]. Genauere Angaben zu pharmakokinetischen Aspekten sind nicht möglich, da nur vereinzelte Studien zur Anwendung von Propacetamol bei Kindern vorliegen.…”

Section: Intravenöse Gabeunclassified

“…So waren nach 20 mg/kg KG Paracetamol oral fast 50% der Kinder während der ersten 2-4 h nach Tonsillektomie ausreichend analgesiert [57].Ebenso wurde mit 30 mg/kg KG Propacetamol intravenös (=15 mg/kg KG wirksame Substanz) in 66% eine ausreichende analgetische Wirkung nach Extremitätenoperationen beobachtet [36]. Auch nach Leistenherniotomie waren Kinder mit 15-20 mg/kg KG Paracetamol rektal suffizient analgesiert, nicht jedoch nach Orchidopexie [87].…”

Section: Analgetische Wirksamkeit Von Paracetamol In Niedriger Dosierungunclassified

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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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“…In this context, the use of intravenous acetaminophen is currently considered as the basic postoperative analgesic due to its low cost and an appropriate safety profile in the management of post-tonsillectomy pain (7). Furthermore, parenteral formulation of acetaminophen has been introduced for children and its pharmacological safety has been established among this age-subgroups (8, 9). …”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial on Analgesic Effects of Intravenous Acetaminophen versus Dexamethasone after Pediatric Tonsillectomy

Faiz¹,

Rahimzadeh²,

Alebouyeh³

et al. 2013

Iran Red Cres Med J

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BackgroundA few studies are available actually comparing the clinical efficacy of intravenous acetaminophen with other medications such as dexamethasone to inhibit postoperative adverse events in children.ObjectivesThis randomized blinded controlled trial was designed to compare controlling status of postoperative events in children after tonsillectomy randomized to receive either intravenous acetaminophen or dexamethasone.Patients and MethodsEighty four children aged between 4 to 13 undergoing tonsillectomy were randomized using a computer-generated schedule to double-blind treatment with intravenous acetaminophen (15 mg/kg) or intravenous dexamethasone (0.1 mg/kg). Children were post-operatively assessed for swallowing pain, pain while opening mouth, ear pain, and postoperative sore throat in recovery room (within one hour after surgery), at the time of admission to the ward, as well as at 12 and 24 hours after surgery, assessed by the objective pain scoring system (OPS; minimum score: 0 = no pain, maximum score: 10 = extreme pain).ResultsThere were no significant differences between the two groups with regard to the severity of postoperative pain due to swallowing or opening mouth measured at the different study time points from postoperative recovery to 24 hours after the surgery. There was no difference in ear pain severity at the time of postoperative recovery, at the admission time to ward and also at 12 hours after surgery; however mean score of ear pain severity was significantly higher in those who administered acetaminophen 24 hours after operation. Also, the mean score severity of sore throat was significantly higher in the acetaminophen compared with the dexamethasone group within 12 hours of surgery. Postoperative vomiting and bleeding were similarly observed between the two study groups. The severity of swallowing pain, pain while opening mouth, ear pain, as well as postoperative sore throat as gradually assuaged within 24 hours of tonsillectomy in both groups, however no between-group differences were observed in the trend of the severity of these events.ConclusionsThe dexamethasone-based regimen may have more advantage over the intravenous acetaminophen regimen for inhibiting pain and PONV following tonsillectomy in children.

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The analgesic efficacy of an injectable prodrug of acetaminophen in children after orthopaedic surgery

Cited by 63 publications

References 0 publications

Acetaminophen Improves Analgesia but Does Not Reduce Opioid Requirement After Major Spine Surgery in Children and Adolescents

Acetaminophen Improves Analgesia but Does Not Reduce Opioid Requirement After Major Spine Surgery in Children and Adolescents

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

A Randomized Controlled Trial on Analgesic Effects of Intravenous Acetaminophen versus Dexamethasone after Pediatric Tonsillectomy

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