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Pre-emptive
consumption of IV paracetamol was better than preventive post-treatment
administration in lowering pain scores and decreasing the use of postoperative
opioids and overall percentage of pediatric dental patients requiring pain
relief.
A recent study was concerned to
find out the efficacy of intravenous (IV) paracetamol by using it as
pre-emptive analgesia when compared with preventive post-treatment
administration in the pediatric dental setting.
This study was designed as a prospective trial, which included 60
noncooperative children of ASA I, II (3–10 years), who had undergone dental
rehabilitation under general anaesthesia. They were randomly divided into two
groups – 1) Pre-emptive group (n= 30) who were given 15 mg/kg of IV paracetamol
before starting the treatment; 2) Preventive group (n = 30) given 15 mg/kg of
paracetamol at the end of treatment. The visual analog scale of faces (VASOF)
was used to measure analgesic efficacy and percentage of children received
postoperative analgesia was also evaluated.
The findings of VASOF revealed that pre-emptive group were significantly lower
compared to the preventive group at 4, 8, 12, and 24 h (0.0146, 0.0188, 0.0085,
and 0.0001, respectively). Very few children in the pre-emptive group got
supplemental fentanyl postoperatively as compared to the preventive group
(27.6%, 58.6%, respectively, P = 0.0170). Time to first rescue dose of fentanyl
postoperatively in the pre-emptive group was later than in the preventive group
(P = 0.0432).
The study concludes that preemptive administration of IV paracetamol provides
lower pain scores. This reduced the percentage of children in need to get
relief from pain and amount of postoperative opioids, compared to preventive
administration.
Int J Paediatr Dent. 2017 Jun 15
Effect of intravenous paracetamol as pre-emptive compared to peventive analgesia in a pediatric dental setting: a prospective randomized study
Kharouba J et al.
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