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Administration of Paracetamol injection could enhance postoperative care and reduce opioid dependency after cardiothoracic surgery in children.
A multi-centre trial conducted across four Pediatric Intensive Care Units in the Netherlands and Belgium has discovered favourable outcomes regarding postoperative pain management in pediatric patients aged 0–3 years undergoing cardiothoracic surgery.
The study involved 208 pediatric patients (after screening of 828 children) who were randomized to receive either intermittent intravenous (IV) paracetamol or continuous morphine as their primary analgesic following a loading dose of 100 mcg/kg morphine at the end of surgery. The primary objective was to assess the impact of IV paracetamol on lowering morphine intake within the first 48 hours after the surgery.
As found, the administration of IV paracetamol reduced the median weight-adjusted cumulative morphine consumption by 79%. In particular, the median weight-adjusted cumulative morphine dose in the first 48 hours of the surgery was 5 times lower in the IV paracetamol group (than in the morphine group.
Importantly, the trial established the non-inferiority of IV paracetamol in terms of the Numeric Rating Scale (NRS) pain scores. The analysis revealed a minimal difference in the proportion of patients with NRS pain scores of 4 and higher between the IV paracetamol and morphine groups.
Critical Care
Intermittent intravenous paracetamol versus continuous morphine in infants undergoing cardiothoracic surgery: a multi-center randomized controlled trial
Gerdien Zeilmaker-Roest et al.
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