Does paracetamol in adjunct to NSAIDS reduce analgesia demand in children undergoing surgery

Abstract

Introduction Opioid medications are very often an important component of pediatric postoperative pain treatment but have been associated with perioperative complications such as nausea, vomiting, constipation, physical dependence, tolerance and respiratory depression [1]. Extensive efforts have been made toward reducing postoperative opioid use in children [2]. Multimodal postoperative analgesia is widely used but lacks evidence of benefit [3]. Aim Our aim is to perform a systematic review and find out if a single dose of paracetamol (enteral or intravenous) given in addition to NSAIDs results in a reduced need for opioid based rescue analgesia compared to NSAID alone in children within 1–4 h after general/orthopedic, oral and maxillofacial surgery. Methods The type of this study is a systematic review of the literature that was conducted based on PRISMA guidelines. Search and analysis of scientific publications were performed using the PubMed. Keywords applied: paracetamol, NSAID, opioid, child, surgery. Double- blind randomized clinical trials, published 2002 - 2022 years were included in the analysis. Study participants – patients aged 1-18 years, study groups: the first group - patients receiving NSAIDs and placebo or NSAID alone, the second group - patients receiving NSAIDs + paracetamol (no dose restriction), types of operations – general/orthopedic surgery, oral, maxillofacial surgery. […].