Intraoperative single-dose intravenous acetaminophen for postoperative analgesia after skin laser irradiation surgery in paediatric patients: a small prospective study [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-10476

Intraoperative single-dose intravenous acetaminophen for postoperative analgesia after skin laser irradiation surgery in paediatric patients: a small prospective study

Syunsuke Kuroki1, Yoshihiro Nagamine1, Yoshihumi Kodama1, Yoko Kadota1, Satoshi Koroki1, Toyoaki Maruta1, Shiho Kanemaru2, Masahiro Amano2, Isao Tsuneyoshi1
1Department Of Anaesthesiology, University Of Miyazaki Hospital, Miyazaki, Japan
2Department Of Dermatology, University Of Miyazaki Hospital, Miyazaki, Japan

Objective: Acetaminophen is an effective analgesic for postoperative pain relief in children. Many drugs such as opioids, NSAIDs, and/or acetaminophen have been used during paediatric skin laser irradiation surgery for postoperative pain relief. However, acetaminophen has some advantages over opioids and opioids are being used less often. We aimed to demonstrate the effectiveness of intravenous acetaminophen during surgery for postoperative pain of paediatric skin laser irradiation.
Methods: Our present study is a small, prospective, double-blinded, randomized controlled trial. Paediatric patients (1-12 years old with an American Society of Anesthesiologists physical status of I-II), scheduled for skin laser irradiation for a nevus or haemangioma between October 2014 and April 2016, were randomized into acetaminophen (n = 9) and placebo (saline, n = 8) groups. The observational face scale (FS) and Behavioural Observational Pain Scale (BOPS) scores were recorded on emergence from anaesthesia, and 1, 2, and 4 hr post-surgery.
Results: Patient characteristics were not significantly different except the irradiation area and surgery time. The observational FS and BOPS scores of acetaminophen group were lower than those of placebo group; median (minimum-maximum) at each recording time: 1(0-2)-0(0-2)-0(0-1)-0(0-2) vs. 2(0-4)-0(0-2) -0(0-2) -0(0-1) and 1(0-3)-1(0-3)-1(0-2)-0(0-1) vs. 2(0-4)-3(0-5)-1(0-4)-0(0-3), p = 0.07 and 0.003, respectively. No differences in post-surgical analgesic use or adverse events were observed.
Conclusion: In this study, we showed that the intravenous acetaminophen group had lower observational FS and BOPS scores in the early postoperative period, however, further studies including a large number of patients are required to confirm our findings.

Keywords: intravenous acetaminophen, pediatrics, skin laser irradiation, prospective study




Corresponding Author: Toyoaki Maruta, Japan


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