Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
Arch Dis Child. 2011 Mar;96(3):301-4. doi: 10.1136/adc.2010.203778. Epub 2011 Jan 12.
Intravenous paracetamol (acetaminophen) has recently been registered for treatment of pain in neonates but the pharmacodynamics, including effects on body temperature, have not been reported.
A pooled analysis on body temperature recordings in neonates exposed to intravenous paracetamol was performed. Body temperature was recorded by skin probe and registered before and every 2 h following initiation of single or repeated intravenous paracetamol administration (up to 48 h). Repeated measures ANOVA and paired analysis were used to quantify differences following paracetamol exposure.
The pooled analysis was based on 99 neonates (median weight 2.7 (range 0.5-5.4) kg, median postmenstrual age 37 (range 27-50) weeks). Based on observations in 93 normothermic (<37.8°C) neonates and six neonates with fever, it was documented that paracetamol administration does not affect body temperature in normothermic patients. In neonates with fever, the median decrease (-0.8°C) is most prominent in the first 2 h (p<0.01) following paracetamol administration with subsequent further normalisation.
Administration of intravenous paracetamol does not result in hypothermia in normothermic neonates. In those with fever, maximal temperature reduction is achieved within 2 h following paracetamol administration.
静脉用对乙酰氨基酚(扑热息痛)最近已注册用于治疗新生儿疼痛,但尚未报告其药效学,包括对体温的影响。
对接受静脉用对乙酰氨基酚治疗的新生儿的体温记录进行了汇总分析。通过皮肤探头记录体温,并在单次或重复静脉用对乙酰氨基酚给药(最长 48 小时)前和给药后每 2 小时记录一次。采用重复测量方差分析和配对分析来量化对乙酰氨基酚暴露后的差异。
汇总分析基于 99 名新生儿(中位数体重 2.7(范围 0.5-5.4)kg,中位数胎龄 37(范围 27-50)周)。基于 93 名体温正常(<37.8°C)新生儿和 6 名发热新生儿的观察结果,证明对乙酰氨基酚给药不会影响体温正常的患者的体温。在发热的新生儿中,给药后 2 小时内(p<0.01)中位数(-0.8°C)下降最明显,随后进一步正常化。
在体温正常的新生儿中,给予静脉用对乙酰氨基酚不会导致体温过低。在发热的新生儿中,最大的体温降低发生在给予对乙酰氨基酚后 2 小时内。