Abdollahi Mohammad-Hasan, Foruzan-Nia Khalil, Behjati Mostafa, Bagheri Babak, Khanbabayi-Gol Mehdi, Dareshiri Shahla, Pishgahi Alireza, Zarezadeh Rafie, Lotfi-Naghsh Nazgol, Lotfi-Naghsh Ainaz, Naghavi-Behzad Mohammad
Department of Anesthesia, Shahid Sadoghi University of Medical Science, Yazd, Iran.
Department of Cardiac Surgery, Shahid Sadoghi University of Medical Science, Yazd, Iran.
Niger Med J. 2014 Sep;55(5):379-83. doi: 10.4103/0300-1652.140376.
Post-operative fever is a common complication of cardiac operations, which is known to be correlated with a greater degree of cognitive dysfunction 6 weeks after cardiac surgery. The aim of the present study was to examine efficacy and safety of single dose intravenous Paracetamol in treatment of post-operative fever in children undergoing cardiac surgery.
In this randomised, double-blind, placebo-controlled clinical trial, 80 children, aged 1-12 years, presenting for open heart surgery were entered in the trial and randomly allocated into two groups: Placebo and Paracetamol. After induction of anaesthesia, 15 mg/kg intravenous Paracetamol solution was infused during 1 h in the Paracetamol group. Patients in placebo group received 15 mg/kg normal saline infusion during the same time. Since the end of operation until next 24 h in intensive care unit, axillary temperature of the two group patients was recorded in 4-h intervals. Any fever that occurred during this period had been treated with Paracetamol suppository (125 mg) and the amount of antipyretic drug consumption for each patient had been recorded. In order to examine the safety of Paracetamol, patients were evaluated for drug complication at the same time.
Mean axillary temperature during first 24 h after operation was significantly lower in Paracetamol group compared with placebo group (P = 0.001). Overall fever incidence during 24 h after operation was higher in placebo group compared with Paracetamol group (P = 0.012). Of Paracetamol group patients, 42.5% compared with 15% of placebo group participants had no consumption of antipyretic agent (Paracetamol suppository) during 24 h after operation (P = 0.001).
This study suggests that single dose administration of intravenous Paracetamol before paediatric cardiac surgeries using cardiopulmonary bypass; reduce mean body temperature in the first 24 h after operation.
术后发热是心脏手术常见的并发症，已知与心脏手术后6周更严重的认知功能障碍相关。本研究的目的是探讨单剂量静脉注射对乙酰氨基酚治疗儿童心脏手术后发热的有效性和安全性。
在这项随机、双盲、安慰剂对照的临床试验中，80名年龄在1至12岁、拟行心脏直视手术的儿童进入试验，并随机分为两组：安慰剂组和对乙酰氨基酚组。麻醉诱导后，对乙酰氨基酚组在1小时内静脉输注15mg/kg对乙酰氨基酚溶液。安慰剂组患者在同一时间接受15mg/kg生理盐水输注。从手术结束到重症监护病房的接下来24小时，每隔4小时记录两组患者的腋窝温度。在此期间发生的任何发热均用对乙酰氨基酚栓剂（125mg）治疗，并记录每位患者的退烧药消耗量。为了检查对乙酰氨基酚的安全性，同时对患者进行药物并发症评估。
与安慰剂组相比，对乙酰氨基酚组术后前24小时的平均腋窝温度显著降低（P = 0.001）。与对乙酰氨基酚组相比，安慰剂组术后24小时的总体发热发生率更高（P = 0.012）。对乙酰氨基酚组42.5%的患者与安慰剂组15%的参与者在术后24小时内未使用退烧药（对乙酰氨基酚栓剂）（P = 0.001）。
本研究表明，在小儿心脏手术体外循环前单剂量静脉注射对乙酰氨基酚可降低术后24小时内的平均体温。
