The analgesic efficacy of acetaminophen, ketoprofen, or their combination for pediatric surgical patients having soft tissue or orthopedic procedures

Anesthesia and Analgesia
Arja HillerTomi Taivainen

Abstract

The combined use of acetaminophen and a nonsteroidal antiinflammatory drug has been shown to provide better postoperative analgesia than either drug alone in several adult studies. However, there are no pediatric studies analyzing similar effects when the currently recommended doses of acetaminophen are used. In a double-blind, placebo-controlled design we randomized 120 children, aged 1-9 yr, undergoing orthopedic or soft tissue surgery, into 3 groups to receive either acetaminophen 60 mg/kg rectally and 40 mg/kg orally, ketoprofen 2 mg/kg IV twice, or the combination of the active drugs. The first drug doses were given at anesthetic induction and the second doses 8 h thereafter. During anesthesia all children received sevoflurane and a continuous infusion of remifentanil. Postoperative pain was evaluated by the behavioral objective pain scale (0-9) for 24 h. The rescue medication was morphine 0.05 mg/kg IV. The primary outcome variable was morphine consumption. For statistical analysis, analysis of variance, chi2 test and Kaplan-Meier survival analysis were used. Morphine requirement was less in the combination than in the acetaminophen group both in the postanesthesia care unit (2.5 +/- 1.7 versus 3.9 +/- 2.1 morphine doses)...Continue Reading

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Citations

Nov 20, 2009·Anesthesia and Analgesia·Christina M SpoffordTimothy J Brennan
Mar 24, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·E MarretC Lejus
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Sep 15, 2016·Journal of Anaesthesiology, Clinical Pharmacology·Daphnée MicheletSouhayl Dahmani
Apr 26, 2018·World Journal for Pediatric & Congenital Heart Surgery·Uri Pollak, Alain Serraf
Oct 1, 2011·The Journal of Craniofacial Surgery·Seyed Mohammad Mireskandari, Jalil Makarem
Nov 23, 2011·Anesthesia and Analgesia·Daphne MicheletSouhayl Dahmani
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Mar 30, 2019·Regional Anesthesia and Pain Medicine·Michelle S KarsSelina Poon

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