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AAP Grand Rounds 2:52-53 (1999) Dosing Guidelines for Rectal Administration of Acetaminophen Prior to Same Day Surgery: Non-surgical ImplicationsSource: Korpela R, Korvenoja P, Meretoja MO. Morphine-sparing effect of acetaminophen in pediatric day-case surgery. Anesthesiology. 1999;91:442447.
This study was designed to evaluate the relative efficacy of different doses of rectal acetaminophen. A randomized, double-blinded, placebo-controlled design was used. One hundred twenty children aged 17 who underwent same day surgery were given 1 dose of rectal acetaminophen after induction of general anesthesia and before the beginning of surgery. The surgeries were herniorraphy (71), adenoidectomy (13), hydrocoelectomy (12), orchidopexy (12), and excision of subcutaneous tumor (12). The children were divided into 4 groups of 30 based on the dose of acetaminophen: 0, 20, 40, and 60 mg/kg. The groups did not differ significantly in the distribution of gender, weight, age, or type of procedure. The children were not given any other analgesics intraoperatively. A PACU (post-anesthesia care unit) nurse, who was unaware of the dose of acetaminophen, administered IV morphine 0.1 mg/kg as needed. Every 10 minutes in the PACU pain was assessed using behavioral and physiologic measurements. The children were kept in the PACU for a minimum of
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