Seeking a viable perioperative preemptive analgesia regimen: a prospective, randomized, controlled, double-blind superiority study of intravenous acetaminophen in children undergoing adenotonsillectomy - Summary - MDSpire
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Seeking a viable perioperative preemptive analgesia regimen: a prospective, randomized, controlled, double-blind superiority study of intravenous acetaminophen in children undergoing adenotonsillectomy
To evaluate the analgesic efficacy and safety of pre-induction intravenous acetaminophen in preschool children undergoing day-case adenotonsillectomy.
Approach:
Key Findings:
FLACC scores were significantly lower in the acetaminophen group at 1 hour post-extubation (median difference −1.0, 95% CI −2.0 to −1.0; P = 0.002).
PACU opioid rescue rates were reduced in the acetaminophen group (20.0% vs. 45.0%; absolute risk difference −25%, 95% CI −44.6 to −5.4%; P < 0.05).
No significant differences were observed in PAED scores, home analgesia use, or 24-hour adverse events.
Early postoperative analgesic benefit was time-limited, with no significant differences at 4, 8, or 24 hours postoperatively.
Interpretation:
Pre-induction intravenous acetaminophen effectively reduces early postoperative pain and PACU opioid requirements without increasing adverse events in preschool children undergoing adenotonsillectomy.
Limitations:
The study was limited to a single center.
The sample size may limit the generalizability of the findings.
Conclusion:
The findings indicate the effectiveness of intravenous acetaminophen in reducing early postoperative pain and opioid requirements in pediatric day-case adenotonsillectomy.
