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Effect of Intravenous Paracetamol on Postoperative Recovery in Children Undergoing Hypospadias Repair under General

Muhammad Saad Yousuf1, Ayesha Saleem2, Abdul Monem1

  • 1Department of Anaesthesiology, The Aga Khan University and Hospital, Karachi, Pakistan.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|January 18, 2025
PubMed

Insights

Adding intravenous paracetamol to caudal ropivacaine did not significantly improve postoperative recovery in children undergoing hypospadias repair. Pain scores and sedation levels showed no significant differences between groups receiving paracetamol or placebo.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Surgical Recovery

Background:

  • Hypospadias repair in children often requires effective postoperative pain management.
  • Caudal analgesia with ropivacaine is a common technique for pediatric pain control.
  • The role of perioperative intravenous paracetamol in conjunction with caudal analgesia needs further investigation.

Purpose of the Study:

  • To evaluate the impact of perioperative intravenous paracetamol combined with caudal ropivacaine on postoperative recovery in pediatric hypospadias repair.
  • To assess pain scores and sedation levels in children receiving the combined analgesic regimen.

Main Methods:

  • A double-blinded randomized controlled trial involving 59 children aged 3-10 years undergoing hypospadias repair.
  • Group P received intravenous paracetamol 15 mg/kg before procedure completion; Group C received a placebo.
  • Pain was assessed using the modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS); sedation was also monitored.

Main Results:

  • While 55% in the paracetamol group and 45% in the placebo group required additional analgesia, this difference was not statistically significant.
  • No significant variations were observed in CHEOPS pain scores or sedation levels between the two groups within the first six hours postoperatively.

Conclusions:

  • Perioperative intravenous paracetamol (15 mg/kg) combined with caudal ropivacaine (0.25%) did not significantly enhance postoperative recovery in pediatric hypospadias repair.
  • The addition of IV paracetamol did not lead to measurable improvements in pain or sedation compared to caudal ropivacaine alone.
Abstract

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