Dashti Gholam Ali, Amini Shahram, Zanguee Elham
Zahedan Univ. of Medical Sciences, Zahedan, Iran.
Middle East J Anaesthesiol. 2009 Jun;20(2):245-9.
Postoperative pain in children is common after adenotonsillectomy. Rectal acetaminophen has been used effectively for postoperative pain management in small children. The aim of this randomized double blind study was to evaluate the prophylactic effect of rectal acetaminophen on postoperative pain management and opioid requirements in children undergoing adenotonsillectomy.
104 children, 7 to 15 yr, ASA I or II scheduled for elective adenotonsillectomy were recruited for the study. Patients were randomized to receive either rectal acetaminophen 40 mg/kg or nothing after induction of standard anesthesia. The postoperative pain was assessed using visual analog scale (VAS) every 2 hours for the first 6 hours. The need for rescue analgesic, intravenous pethedine of 0.5 mg/kg, was recorded at 24 hours after surgery.
Pain scores were significantly lower in acetaminophen group at different times (p<0.001) and needed less rescue analgesic (p<0.001).
We conclude that prophylactic rectal acetaminophen is effective in reducing pain after adenotonsillectomy and postoperative analgesic requirement.
儿童腺样体扁桃体切除术后疼痛很常见。直肠用对乙酰氨基酚已被有效用于小儿术后疼痛管理。这项随机双盲研究的目的是评估直肠用对乙酰氨基酚对接受腺样体扁桃体切除术儿童的术后疼痛管理及阿片类药物需求的预防作用。
招募104名7至15岁、ASA I或II级、计划进行择期腺样体扁桃体切除术的儿童参与研究。患者在标准麻醉诱导后随机接受40 mg/kg直肠用对乙酰氨基酚或不接受任何处理。术后前6小时每2小时使用视觉模拟量表（VAS）评估术后疼痛。记录术后24小时使用补救镇痛药（0.5 mg/kg静脉注射哌替啶）的需求情况。
对乙酰氨基酚组在不同时间的疼痛评分显著更低（p<0.001），且所需补救镇痛药更少（p<0.001）。
我们得出结论，预防性直肠用对乙酰氨基酚可有效减轻腺样体扁桃体切除术后的疼痛及术后镇痛需求。
