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.