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Effect of Pre-Emptive Paracetamol Infusion on Postoperative Analgesic Consumption in Children Undergoing Elective
Ana Cicvaric1, Dalibor Divkovic2,3, Ozana Katarina Tot1,3
1Department of Anesthesiology, Resuscitation, and ICU, Osijek University Hospital, Osijek, Croatia.
Insights
Pre-emptive analgesia showed effectiveness in controlling postoperative pain for children undergoing herniorrhaphy. However, it did not significantly reduce overall analgesic drug consumption in this study.
Area of Science:
- Pediatric Surgery
- Pain Management
- Anesthesiology
Background:
- Pre-emptive analgesia is theorized to reduce postoperative pain and opioid use.
- Herniorrhaphy is a common pediatric surgical procedure.
Purpose of the Study:
- To evaluate the efficacy of pre-emptive analgesia in reducing postoperative pain and analgesic consumption in children undergoing herniorrhaphy.
Main Methods:
- Retrospective analysis of medical records from two groups of children undergoing herniorrhaphy.
- One group received no pre-emptive analgesia (NA), while the other received intravenous paracetamol at least 1 hour before surgery (PA).
- Postoperative pain was assessed using validated scales, and total paracetamol and opioid consumption were recorded within 24 hours.
Main Results:
- No statistically significant difference was found in total paracetamol consumption between the NA and PA groups (1157.8±908.8 mg vs. 983.0±536.4 mg, p=0.202).
- Total opioid consumption also showed no significant difference (5.8±4.7 vs. 7.0±4.6 morphine equivalents, p=0.160).
- Discharge times were similar between the groups (2.1±0.3 vs. 2.0±0.3 days, p=0.13).
Conclusions:
- Pre-emptive analgesia was effective for postoperative pain control in pediatric herniorrhaphy.
- It did not lead to a reduction in overall analgesic drug consumption.
- Multimodal pain management strategies may be beneficial for decreasing analgesic drug use.
Objective:
Studies have suggested that pre-emptive analgesia may decrease postoperative pain and opioid consumption. This study was undertaken to determine whether pre-emptive analgesia reduces postoperative pain and total paracetamol and opioid consumption in children undergoing herniorrhaphy.
Methods:
In this retrospective study, medical records were analysed before and after the pre-emptive analgesia regimen was introduced. Demographic data, perioperative drug consumption and discharge time were recorded. In the first group, no pre-emptive analgesia (NA; year, 2011; n=60) was given and in the second group, the pre-emptive analgesia (PA) paracetamol 10-15 mg kg-1 was given intravenously in the surgical ward at least 1 h before the surgical procedure (year 2013; n=60). Postoperative pain determining supplemental pain medications was scored using a Faces Pain Scale or visual analogue scale. Total paracetamol and opioid consumption during 24 perioperative hours was registered for all patients. The statistical analysis was performed using t test and Chi-square test.
Results:
The mean age of children was 69.6±49.9 and 58.7±32.4 months (p=0.157), and the mean body mass index (BMI) was 18.3±8.8 kg m-2 and 16.4±3.7 kg m-2 (p=0.125) in the NA and PA groups, respectively. Total paracetamol consumption was 1157.8±908.8 mg vs. 983.0±536.4 mg (p=0.202), and the total opioid consumption was 5.8±4.7 in the NA group and 7.0±4.6 morphine equivalents in the PA group (p=0.160). No differences in the discharge time between the groups were observed (2.1±0.3 vs. 2.0±0.3 days, p=0.13).
Conclusion:
PA was proven to be efficient in the terms of postoperative pain control but did not reduce the overall analgesic drug consumption in the children undergoing elective herniorrhaphy. Multimodal pain treatment may decrease the consumption of analgesic drugs.
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