Analgesic efficacy of paracetamol in children using tonsillectomy as a pain model

Anaesthesia and Intensive Care
B AndersonG Woollard

Abstract

The analgesic efficacy of paracetamol was assessed in a prospective, randomized, double-blinded study of 100 children undergoing tonsillectomy with or without adenoidectomy. Fifty children were given paracetamol elixir 40 mg/kg 40 minutes preoperatively (Group A); the remaining 50 children were given an oral placebo 40 minutes preoperatively and paracetamol suppositories 40 mg/kg after induction of anaesthesia (Group B). Paracetamol was the only analgesic given and was given either orally or rectally in order to produce high variations in plasma paracetamol concentrations postoperatively. At 30 minutes after the end of surgery a pain score (0-10) was obtained and a venous blood sample was taken for serum paracetamol concentration analysis. Children given paracetamol elixir had a higher mean paracetamol concentration (0.15 [SD 0.06] mmol/l vs 0.05 [SD 0.03] mmol/l, P < 0.001) and a lower median pain score (5 vs 7, P < 0.02) than those who were given suppositories. The use of rescue morphine was higher (10 vs 23, P < 0.001) in the latter group. The incidence of nausea and vomiting was the same in both groups (20%) during the 24 hour postoperative period. Plasma paracetamol concentrations of 0.066-0.132 mmol/l are known to reduce ...Continue Reading

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Citations

Feb 10, 1999·Anesthesiology·B J AndersonM Mahadevan
Mar 10, 2001·Paediatric Anaesthesia·J RømsingG Ravn
Jan 11, 2001·Acta Anaesthesiologica Scandinavica·A AranaT G Hansen
Oct 3, 2006·Current Opinion in Anaesthesiology·G Allen Finley
Nov 1, 2015·Pain and Therapy·Maurizio de Martino, Alberto Chiarugi
Jul 20, 1999·Paediatric Anaesthesia·I S Hatcher, C G Stack
May 13, 1999·Paediatric Anaesthesia·B J AndersonM J Wardill
Aug 12, 1999·Anesthesiology·R KorpelaO A Meretoja
Feb 11, 2000·Acta Anaesthesiologica Scandinavica·T T NiemiP H Rosenberg
Oct 4, 2006·Current Opinion in Anaesthesiology·M Jöhr
Jan 8, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Charles J Coté, Stephen H Sheldon
May 28, 2008·Paediatric Anaesthesia·Richard HowardUNKNOWN Association of Paediatric Anaesthetists of Great Britain and Ireland
Dec 4, 1998·Paediatric Anaesthesia·B J Anderson
Nov 9, 2007·Current Opinion in Anaesthesiology·Anil Gupta
May 28, 2008·Paediatric Anaesthesia·Richard HowardUNKNOWN Association of Paediatric Anaesthetists of Great Britain and Ireland
Mar 20, 2010·European Journal of Clinical Pharmacology·Monique M de MaatHuibert H Ponssen
Oct 30, 2014·Frontiers in Genetics·Anne E KrasniakWanqing Liu
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Feb 8, 2020·Annals of Pediatric Cardiology·Ashish SainiShriprasad R Deshpande
Jan 11, 2001·Acta Anaesthesiologica Scandinavica·A SchmidtJ Akeson
Jan 12, 2010·Paediatric Anaesthesia·Michael TremlettAndrew Wolf
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Jan 25, 2011·Expert Opinion on Pharmacotherapy·Wai Yin MakTheresa Hui
Apr 25, 2012·Pain Practice : the Official Journal of World Institute of Pain·Neil K SinglaMike A Royal

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