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Comparison of Monotherapy Versus Combination of Intravenous Ibuprofen and Propacetamol (Acetaminophen) for Reduction of Postoperative Opioid Administration in Children Undergoing Laparoscopic Hernia Repair: A Double-Blind Randomized Controlled Trial

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Affiliated Authors
박지훈
Alternative Author(s)
Park, Ji Hoon
Journal Title
Anesthesia and analgesia.
ISSN
1526-7598
Issued Date
2021
Abstract
BACKGROUND:
Extensive efforts have been made toward reducing postoperative opioid use in children. In this study, we assessed whether propacetamol, or a nonsteroidal anti-inflammatory drug (NSAID), or their combination could effectively reduce opioid use in children after laparoscopic inguinal hernia repair.

METHODS:
This randomized, double-blind clinical trial included 159 children aged 6 months to 6 years. Children were allocated into 1 of the following 3 groups: group I was treated with 10 mg·kg−1 ibuprofen, group P was treated with 30 mg·kg−1 propacetamol, and group I + P was treated with both drugs in their respective concentrations. If the face–legs–activity–crying–consolability (FLACC) score was ≥4 during the postanesthesia care unit stay, 1.0 µg·kg−1fentanyl was administered as a rescue analgesic. The number of patients who received rescue fentanyl in the postanesthesia care unit was defined as the primary outcome; this was analyzed using the χ2 test. The secondary outcomes included the FLACC and the parents' postoperative pain measure (PPPM) scores until the 24-hour postoperative period.

RESULTS:
Among the 144 enrolled patients, 28.6% in group I, 66.7% in group P, and 12.8% in group I + P received rescue fentanyl in the postanesthesia care unit (P < .001). The highest FLACC score was lower in group I + P than in either group I or P (P = .007 and P < .001, respectively). Group I + P presented significantly lower PPPM scores than group P at 4 and 12 hours postoperative (P = .03 and .01, respectively).

CONCLUSIONS:
The use of ibuprofen plus propacetamol immediately following laparoscopic hernia repair surgery in children resulted in the reduced use of an opioid drug compared with the use of propacetamol alone.
Department
Dept. of Anesthesiology &amp; Pain Medicine (마취통증의학)
Publisher
School of Medicine (의과대학)
Citation
Lee, Hye-Mi. (2021). Comparison of Monotherapy Versus Combination of Intravenous Ibuprofen and Propacetamol (Acetaminophen) for Reduction of Postoperative Opioid Administration in Children Undergoing Laparoscopic Hernia Repair: A Double-Blind Randomized Controlled Trial. Anesthesia and analgesia., 133(1), 168-175. doi: 10.1213/ANE.0000000000005284
Type
Article
DOI
10.1213/ANE.0000000000005284
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/43554
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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