The efficacy of intravenous paracetamol versus dipyrone for postoperative analgesia after day-case lower abdominal surgery in children with spinal anesthesia: a prospective randomized double-blind placebo-controlled study

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• 作者：Esra Caliskan (1) (3)
  Mesut Sener (1)
  Aysu Kocum (1)
  Nesrin Bozdogan Ozyilkan (1)
  Semire Serin Ezer (2)
  Anis Aribogan (1)
  
• 关键词：Pediatric spinal anesthesia ; Paracetamol ; Dipyrone ; Postoperative pain
• 刊名：BMC Anesthesiology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：465 KB
• 参考文献：1. Kraemer WF: Treatment of acute pediatric pain. / Semin Pediatr Neurol 2010,17(4):268-74. CrossRef
  2. Kokki H: Spinal blocks. / Pediatr Anesth 2012,22(1):56-4. CrossRef
  3. Yaster M: Multimodal analgesia in children. / Eur J Anaesthesiol 2010,27(10):851-57. CrossRef
  4. Marret E, Kurdi O, Zufferey P, Bonnet F: Effects of nonsteroidal anti-inflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. / Anesthesiology 2005,102(6):1249-260. CrossRef
  5. Uysal HY, Takmaz SA, Yaman F, Baltaci B, Basar H: The efficacy of intravenous paracetamol versus tramadol for postoperative analgesia after adenotonsillectomy in children. / J Clin Anesth 2011,23(1):53-7. CrossRef
  6. Wong A, Sibbald A, Ferrero F, Plager M, Santolaya ME, Escobar AM, Campos S, Barragan S, De Leon GM, Kesselring GL, Fever Pediatric Study Group: Antipyretic effects of dipyrone versus ibuprofen versus acetaminophen in children: results of a multinational, randomized, modified double-blind study. / Clin Pediatr (Phila) 2001,40(6):313-24. CrossRef
  7. Kokki H, Tuovinen K, Hendolin H: Spinal anaesthesia for paediatric day-case surgery: a double-blind, randomized, parallel group, prospective comparison of isobaric and hyperbaric bupivacaine. / Br J Anaesth 1998,81(4):502-06. CrossRef
  8. Walker SM, Franck LS, Fitzgerald M, Myles J, Stocks J, Marlow N: Long-term impact of neonatal intensive care and surgery on somatosensory perception in children born extremely preterm. / Pain 2009,141(1-):79-7. CrossRef
  9. Cal??kan E, Sener M, Ko?um A, Bozdo?an N, Ar?bo?an A: Our experiences with spinal anesthesia in pediatric patients. / Agri 2011,23(3):100-06. CrossRef
  10. Taddio A, Katz J: The effects of early pain experience in neonates on pain responses in infancy and childhood. / Pediatr Drugs 2005,7(4):245-57. CrossRef
  11. Mather L, Mackie J: The incidence of postoperative pain in children. / Pain 1983,15(3):271-82. CrossRef
  12. Fitzgerald M, Beggs S: The neurobiology of pain: developmental aspects. / Neuroscientist 2001,7(3):246-57. CrossRef
  13. Henneberg SW, Nilsson LB: Acute paediatric pain. / Current Anaesth Crit Care 2007,18(3):126-34. CrossRef
  14. Taddio A, Nulman I, Koren BS, Stevens B, Koren G: A revised measure of acute pain in infants. / J Pain Symptom Manage 1995,10(6):456-63. CrossRef
  15. Anand KJ, Hall RW: Pharmacological therapy for analgesia and sedation in the newborn. / Arch Dis Child Fetal Neonatal Ed 2006,91(6):F448-F453. CrossRef
  16. ?vani G, Tonetti F, Mossetti V: Update on postoperative analgesia in children. / Minerva Anestesiol 2005,71(9):501-05.
  17. Sang CN, Berde CB: A multicenter study on safety and risk factors in pediatric regional analgesia. / Anesthesiology 1994,81(3A):A1387. CrossRef
  18. Kokki H, Hendolin H, Turunen M: Postdural puncture headache and transient neurologic symptoms in children after spinal anesthesia using cutting and pencil point paediatric spinal needles. / Acta Anaesthesiol Scand 1998,42(9):1076-082. CrossRef
  19. Alhashemi JA, Daghistani MF: Effects of intraoperative i.v. acetaminophen vs i.m. meperidine on post-tonsillectomy pain in children. / Br J Anaesth 2006,96(6):790-95. CrossRef
  20. Verghese ST, Hannallah RS: Acute pain management in children. / J Pain Res 2010,15(3):105-23. CrossRef
  21. Wilson-Smith EM, Morton NS: Survey of i.v.paracetamol (acetaminophen) use in neonates and infants under 1 year of age by UK anesthetists. / Pediatr Anaesth 2009,19(4):329-37. CrossRef
  22. Ohnesorge H, Bein B, Hanss R, Francksen H, Mayer L, Scholz J, Tonner PH: Paracetamol versus metamizol in the treatment of postoperative pain after breast surgery: a randomized controlled trial. / Eur J Anaesthesiol 2009,26(8):648-53. CrossRef
  23. Grundman U, W?rnle C, Biedler A, Kreuer S, Wrobel M, Wilhelm W: The efficacy of the non-opioid analgesics parecoxib, paracetamol and metamizol for postoperative pain relief after lumbar microdiscectomy. / Anesth Analg 2006,103(1):217-22. CrossRef
  24. Landwehr S, Kiencke P, Giesecke T, Eggert D, Thumann G, Kampe S: A comparison between IV paracetamol and IV metamizol for postoperative analgesia after retinal surgery. / Curr Med Res Opin 2005,21(10):1569-575. CrossRef
  25. Kampe S, Warm M, Landwehr S, Dagtekin O, Haussmann S, Paul M, Pilgram B, Kiencke P: Clinical equivalence of IV paracetamol compared to IV dipyrone for postoperative analgesia after surgery for breast cancer. / Curr Med Res Opin 2006,22(10):1949-954. CrossRef
  26. Granry JC, Rod B, Monrigal JP, Merckx J, Berniere J, Jean N, Boccard E: The analgesic efficacy of an injectable prodrug of acetaminophen in children after orthopedic surgery. / Pediatr Anaesth 1997,7(6):445-49. CrossRef
  27. Hiller A, Helenius I, Nurmi E, Neuvonen PJ, Kaukonen M, Hartikainen T, Korpela R, Taivainen T, Meretoja OA: Acetaminophen improves analgesia but does not reduce opioid requirement after major pine surgery in children and adolescents. / Spine (Phila Pa 1976) 2012,37(20):E1225-E1231. CrossRef
  28. Cakan T, Inan N, Culhaoglu S, Bakkal K, Basar H: Intravenous paracetamol improves the quality of postoperative analgesia but not decrease narcotic requirements. / J Neurosurg Anesthesiol 2008,20(3):169-73. CrossRef
  29. Duman A, Ap?l?ogullar? S, Duman I: Effects of intrathecal fentanyl on quality of spinal anesthesia in children undergoing inguinal hernia repair. / Pediatr Anaesth 2010,20(6):530-36. CrossRef
  30. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/13/34/prepub
  
• 作者单位：Esra Caliskan (1) (3)
  Mesut Sener (1)
  Aysu Kocum (1)
  Nesrin Bozdogan Ozyilkan (1)
  Semire Serin Ezer (2)
  Anis Aribogan (1)
  
  1. Department of Anesthesiology and Reanimation, Faculty of Medicine, Baskent University, Ankara, Turkey
  3. Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Baraj Yolu, 1. Durak, No: 37, 01110, Seyhan, Adana, Turkey
  2. Department of Pediatric Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
  
• ISSN：1471-2253

文摘

Background A multimodal and preventative approach to providing postoperative analgesia is becoming increasingly popular for children and adults, with the aim of reducing reliance on opioids. We conducted a prospective, randomized double-blind study to compare the analgesic efficacy of intravenous paracetamol and dipyrone in the early postoperative period in school-age children undergoing lower abdominal surgery with spinal anesthesia. Methods Sixty children scheduled for elective lower abdominal surgery under spinal anesthesia were randomized to receive either intravenous paracetamol 15?mg/kg, dipyrone 15?mg/kg or isotonic saline. The primary outcome measure was pain at rest, assessed by means of a visual analog scale 15?min, 30?min, 1?h, 2?h, 4?h and 6?h after surgery. If needed, pethidine 0.25?mg/kg was used as the rescue analgesic. Time to first administration of rescue analgesic, cumulative pethidine requirements, adverse effects and complications were also recorded. Results There were no significant differences in age, sex, weight, height or duration of surgery between the groups. Pain scores were significantly lower in the paracetamol group at 1?h (P--.030) and dipyrone group at 2?h (P--.010) when compared with placebo. The proportion of patients requiring rescue analgesia was significantly lower in the paracetamol and dipyrone groups than the placebo group (vs. paracetamol P--.037; vs. dipyrone P--.020). Time to first analgesic requirement appeared shorter in the placebo group but this difference was not statistically significant, nor were there significant differences in pethidine requirements, adverse effects or complications. Conclusion After lower abdominal surgery conducted under spinal anesthesia in children, intravenous paracetamol appears to have similar analgesic properties to intravenous dipyrone, suggesting that it can be used as an alternative in the early postoperative period. Trial registration Clinical Trials.gov. Identifier: NCT01858402.