Examination of acetaminophen for outpatient management of postoperative pain in children

• Published in: Pediatric anesthesia Vol. 8; no. 3; pp. 235 - 239
• Main Authors: RØMSING, JANNE, HERTEL, STEEN, HARDER, ANNE, RASMUSSEN, METTE
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.05.1998; Blackwell
• Subjects: acetaminophen; Acetaminophen - administration & dosage; Acetaminophen - adverse effects; Acetaminophen - therapeutic use; Administration, Oral; Administration, Rectal; Adolescent; Ambulatory Care; analgesia; Analgesics; Analgesics - administration & dosage; Analgesics - therapeutic use; Analgesics, Non-Narcotic - administration & dosage; Analgesics, Non-Narcotic - adverse effects; Analgesics, Non-Narcotic - therapeutic use; Biological and medical sciences; Body Weight; Child; Child, Preschool; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Male; Medical sciences; Neuropharmacology; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - prevention & control; Patient Discharge; Pharmacology. Drug treatments; postoperative; tonsillectomy; Tonsillectomy - adverse effects; Human; Postoperative; Oral administration; Rectal administration; Dose activity relation; Analgesia; Chemotherapy; Paracetamol; Analgesic; Pain; Treatment; Tonsillectomy; Surgery; ENT disease; Application method; Ambulatory; Child; Comparative study
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1046/j.1460-9592.1998.00768.x

We have examined acetaminophen (paracetamol) dosing for outpatient management of posttonsillectomy pain in children. Forty children, 5–15 years of age, undergoing tonsillectomy and their parents were randomly assigned to use a scheduled administration of acetaminophen in weight appropriate doses, 60 mg·kg−1·24 h−1 orally, 90 mg·kg−1·24 h−1 rectally, or to use acetaminophen ‘as needed’ according to present standards (control group). Postoperative pain was assessed by the child using the poker chip tool for the first three days after discharge. The prevalence of pain amongst all the children was high. The second day after discharge 22%–64% of the children in the study group and 36%–73% of the children in the control group rated severe pain. Recommended dose ranges of acetaminophen do not provide sufficient pain relief in children following tonsillectomy. Further studies are required to determine, whether higher doses of acetaminophen or analgesics with different analgesic properties will lead to improved analgesia in children following tonsillectomy.