Administration of paracetamol versus dipyrone by intravenous patient-controlled analgesia for postoperative pain relief in children after tonsillectomy

Abstract

Background and objective: We compared the efficacy of intravenous (iv) paracetamol versus dipyrone via patient-controlled analgesia (PCA) for postoperative pain relief in children.

Methods: The study was composed of 120 children who had undergone elective tonsillectomy after receiving general anesthesia. Patients were divided into 3 groups according to the dosage of postoperative intravenous-patient-controlled analgesia: paracetamol, dipyrone, or placebo. Pain was evaluated using a 0- to 100-mm visual analog scale and 1- to 4-pain relief score at 30 min, 1, 2, 4, 6, 12, and 24h postoperatively. Pethidine (0.25 mg kg 1) was administered intravenously to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24h postoperatively, and treatment related adverse effects were noted.

Results: Postoperative visual analog scale scores were significantly lower with paracetamol group compared with placebo group at 6h (p < 0.05), dipyrone group compared with placebo group at 30 min and 6 h (p <0.05). No significant differences regarding visual analog scale values at 1, 2, 4, 12, and 24h were found. No significant differences were found between groups with respect to pain relief score (p >0.05). Postoperative pethidine requirements were significantly lower with paracetamol and dipyrone groups compared with placebo group (62.5%, 68.4% vs 90%, p < 0.05). No significant differences were found between groups with respect to nausea, vomiting and the any other adverse effects of the drugs (p >0.05).

Conclusions: Paracetamol and dipyrone have well tolerability profile and effective analgesic properties when administered iv-PCA for postoperative analgesia in children after tonsillectomy. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.