Effect of intravenous paracetamol as pre‐emptive compared to preventive analgesia in a pediatric dental setting: a prospective randomized study. Issue 1 (15th June 2017)

• Record Type: Journal Article
• Authors: Kharouba, Johny; Hawash, Nasir; Peretz, Benjamin; Blumer, Sigalit; Srour, Yara; Nassar, Marry; Sabbah, Mulham; Safadi, Anan; Khorev, Alexey; Somri, Mostafa
• Is Part Of: International journal of paediatric dentistry. Volume 28:Issue 1(2018)
• Page Start: 83
• Page End: 91
• Publication Date: 2017-06-15
• Subjects: Pedodontics -- Periodicals; 617.645
• DOI: 10.1111/ipd.12311
• Languages: English
• ISSNs: 0960-7439

Abstract

Abstract : 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.