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Effect of intravenous paracetamol as pre‐emptive compared to preventive analgesia in a pediatric dental setting: a prospective randomized study
Author(s) -
Kharouba Johny,
Hawash Nasir,
Peretz Benjamin,
Blumer Sigalit,
Srour Yara,
Nassar Marry,
Sabbah Mulham,
Safadi Anan,
Khorev Alexey,
Somri Mostafa
Publication year - 2018
Publication title -
international journal of paediatric dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.183
H-Index - 62
eISSN - 1365-263X
pISSN - 0960-7439
DOI - 10.1111/ipd.12311
Subject(s) - medicine , fentanyl , anesthesia , analgesic , acetaminophen , prospective cohort study , regimen , visual analogue scale , randomized controlled trial , surgery
Background Efficacy of pre‐emptive analgesia compared to preventive regimen, managing postoperative pain is still controversial. Aim Evaluating the efficacy of intravenous ( IV ) paracetamol as pre‐emptive analgesia compared to preventive post‐treatment administration in pediatric dental setting. Design In a prospective trial, 60 noncooperative children of ASA I, II aged 3–10 years who underwent dental rehabilitation under general anesthesia were randomly divided into two groups. Pre‐emptive group ( n = 30) received 15 mg/kg of IV paracetamol before the start of treatment. Preventive group ( n = 30) received 15 mg/kg of paracetamol at the end of treatment. Analgesic efficacy was measured by visual analog scale of faces ( VASOF ), percentage of children received postoperative analgesia. Results The VASOF results in the 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). Less children in the pre‐emptive group received supplemental fentanyl postoperatively 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). Conclusions Administration of IV paracetamol pre‐emptively provides lower pain scores, and a decreased percentage of children required pain relief and less amount of postoperative opioids, compared to preventive administration.