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 | DOI: 10.5152/TJAR.2019.10476  

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 Kouroki1, 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 analgesic that shows efficacy in postoperative pain relief in children. Many drugs such as opioids, non-steroidal anti-inflammatory drugs, and/or acetaminophen have been used in 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 (IV) acetaminophen during surgery for postoperative pain in paediatric skin laser irradiation.
Methods: The 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 I and II), scheduled for skin laser irradiation for a nevus or haemangioma between October 2014 and April 2016 were randomized into the acetaminophen (n=9) and placebo (saline, n=8) groups. The observational face scale (FS) and the 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 with regard to the irradiation area and surgery time. The observational FS and BOPS scores of the acetaminophen group were lower than those of the 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 p=0.003, respectively. No differences in post-surgical analgesic use or adverse events were observed.
Conclusion: In this study, we showed that the IV 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, prospective study, skin laser irradiation




Corresponding Author: Toyoaki Maruta, Japan


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