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Fentanyl-sparing effect of acetaminophen as a mixture of fentanyl in intravenous parent-/nurse-controlled analgesia after pediatric ureteroneocystostomy

 Jeong-Yeon Hong  ;  Won Oak Kim  ;  Bon Nyeo Koo  ;  Jin Sun Cho  ;  Eun H. Suk  ;  Hae Keum Kil 
 ANESTHESIOLOGY, Vol.113(3) : 672-677, 2010 
Journal Title
Issue Date
Acetaminophen/administration & dosage* ; Analgesia, Patient-Controlled/methods* ; Child, Preschool ; Cystostomy/adverse effects* ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Fentanyl/administration & dosage* ; Humans ; Infant ; Infusions, Intravenous ; Male ; Nurse's Role* ; Pain Measurement/methods ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Parents ; Prospective Studies ; Ureterostomy/adverse effects*
BACKGROUND: Although acetaminophen has been used widely and is well tolerated in children, its efficacy and safety have not been clarified when combined with an opioid in intravenous parent-/nurse-controlled postoperative analgesia. METHODS: Sixty-three children (aged 6-24 months) who had undergone elective ureteroneocystostomies were enrolled in this prospective, randomized, double-blinded study. After the surgery, an analgesic pump was programmed to deliver fentanyl at a basal infusion rate of 0.25 microg.kg(-1).h(-1) and 0.25 microg/kg bolus after a loading dose of 0.5 microg/kg(-1). In the fentanyl-acetaminophen group, acetaminophen was coadministered as a solution mixture at a basal infusion rate of 1.5 mg.kg(-1).h(-1) and 1.5 mg/kg bolus after a loading dose of 15 mg/kg, whereas saline was administered to the fentanyl group. RESULTS: Postoperative pain scores were similar between the two groups. The total dose (micrograms per kilogram per day, mean+/-SD) of fentanyl at postoperative days 1 (8.3+/-3.7 vs. 18.1+/-4.6, P=0.021) and 2 (7.0+/-2.4 vs. 16.6, P=0.042) was significantly less in the fentanyl-acetaminophen group compared with that in the fentanyl group. The incidences of vomiting (16.1 vs. 56.3%, P=0.011) and sedation (9.7 vs. 46.9%, P=0.019) were significantly lower in the fentanyl-acetaminophen group than those in the fentanyl group. CONCLUSIONS: Acetaminophen has significant fentanyl-sparing effects and reduces side effects when combined with fentanyl in intravenous parent-/nurse-controlled analgesia for postoperative pediatric pain management.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kil, Hae Keum(길혜금)
Kim, Won Oak(김원옥)
Hong, Jeong Yeon(홍정연)
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