Comparison of preemptive and preventive intravenous acetaminophen on opioid consumption in pediatrics undergoing posterior spinal fusion surgery : a randomized controlled trial
Background: Posterior spinal fusion (PSF), commonly used for adolescent idiopathic scoliosis (AIS), causes severe postoperative pain. Intravenous (IV) administration of acetaminophen has shown promise for opioid-sparing analgesia; however, its analgesic effect and optimal timing for its standard use remain unclear. Our study aimed to evaluate the analgesic effect and optimal timing of IV acetaminophen administration in pediatric and adolescent patients undergoing PSF and requiring adequate pain control.
Methods: This prospective, randomized, triple-blind trial was conducted in patients aged 11-20 undergoing PSF. Participants were randomized into three groups: the preemptive group (received IV acetaminophen 15 mg/kg after anesthetic induction/before surgical incision), the preventive group (received IV acetaminophen 15 mg/kg at the end of surgery/before skin closure), and the placebo group. The primary outcome was cumulative opioid consumption during the first 24 h postoperatively.
Results: Among the 99 enrolled patients, the mean ± standard deviation (SD) amount of opioid consumption during the postoperative 24 h was 60.66 ± 23.84, 52.23 ± 22.43, and 66.70 ± 23.01 mg in the preemptive, preventive, and placebo groups, respectively (overall p = 0.043). A post hoc analysis revealed that the preventive group had significantly lower opioid consumption than the placebo group (p = 0.013). However, no significant differences between the groups were observed for the secondary outcomes.
Conclusions: The preventive administration of scheduled IV acetaminophen reduces cumulative opioid consumption without increasing the incidence of drug-induced adverse events in pediatric and adolescent patients undergoing PSF.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Korean journal of anesthesiology - (2024) vom: 20. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kim, Yeon Ju [VerfasserIn] |
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| Links: |
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| Themen: |
Acetaminophen |
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| Anmerkungen: |
Date Revised 21.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.4097/kja.23747 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368730115 |
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| 100 | 1 | |a Kim, Yeon Ju |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of preemptive and preventive intravenous acetaminophen on opioid consumption in pediatrics undergoing posterior spinal fusion surgery |b a randomized controlled trial |
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| 500 | |a Date Revised 21.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Background: Posterior spinal fusion (PSF), commonly used for adolescent idiopathic scoliosis (AIS), causes severe postoperative pain. Intravenous (IV) administration of acetaminophen has shown promise for opioid-sparing analgesia; however, its analgesic effect and optimal timing for its standard use remain unclear. Our study aimed to evaluate the analgesic effect and optimal timing of IV acetaminophen administration in pediatric and adolescent patients undergoing PSF and requiring adequate pain control | ||
| 520 | |a Methods: This prospective, randomized, triple-blind trial was conducted in patients aged 11-20 undergoing PSF. Participants were randomized into three groups: the preemptive group (received IV acetaminophen 15 mg/kg after anesthetic induction/before surgical incision), the preventive group (received IV acetaminophen 15 mg/kg at the end of surgery/before skin closure), and the placebo group. The primary outcome was cumulative opioid consumption during the first 24 h postoperatively | ||
| 520 | |a Results: Among the 99 enrolled patients, the mean ± standard deviation (SD) amount of opioid consumption during the postoperative 24 h was 60.66 ± 23.84, 52.23 ± 22.43, and 66.70 ± 23.01 mg in the preemptive, preventive, and placebo groups, respectively (overall p = 0.043). A post hoc analysis revealed that the preventive group had significantly lower opioid consumption than the placebo group (p = 0.013). However, no significant differences between the groups were observed for the secondary outcomes | ||
| 520 | |a Conclusions: The preventive administration of scheduled IV acetaminophen reduces cumulative opioid consumption without increasing the incidence of drug-induced adverse events in pediatric and adolescent patients undergoing PSF | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acetaminophen | |
| 650 | 4 | |a Analgesics | |
| 650 | 4 | |a Opioid | |
| 650 | 4 | |a Pain | |
| 650 | 4 | |a Pediatrics | |
| 650 | 4 | |a Postoperative | |
| 650 | 4 | |a Prospective studies | |
| 700 | 1 | |a Kim, Ha-Jung |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Sehee |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hyungtae |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Choon Sung |e verfasserin |4 aut | |
| 700 | 1 | |a Hwang, Chang Ju |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Jae Hwan |e verfasserin |4 aut | |
| 700 | 1 | |a Ro, Young-Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Koh, Won Uk |e verfasserin |4 aut | |
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| 856 | 4 | 0 | |u http://dx.doi.org/10.4097/kja.23747 |3 Volltext |
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