Substantiation use method of preemptive analgesia with acetaminophen for pain treatment on early postoperative period in children

The anesthesiologist and specialist on medical emergency conditions, Pediatrician

Vinnytsya National Pirogov Memorial Medical University

The aim of the study was to improve the efficiency of non-narcotic analgesics for treatment of postoperative pain.

Materials and Methods. The study was performed in 37 children ((3.2 ± 0.8) years) after surgery: retroperitoneal space tumors – 27 patients (73 %), renal tumors – 8 children (22 %), ovarian tumors – 2 patients (5 %). The first group – 19 patients used continuous infusion of fentanyl as analgesics in combination with preemptive analgesia with acetaminophen, the second group of 18 children used only continuous infusion of fentanyl as analgesics. Evaluating the effectiveness of anesthesia was performed using the method of visual analogue scale, vital signs and biochemical indices were studied (blood glucose and cortisol in the blood), central hemodynamics: stroke volume, cardiac output.

Results and Discussion. The average amount of points that characterized the intensity of pain in early postoperative period, at all stages of the study, according to visual analogue scale, as well as levels of hemodynamic and respiratory lung function, stress hormones blood level and gas composition of the expiratory air in patients from the first group were significantly lower than the corresponding values of the indices in the second group (р < 0.05).

Conclusions. Comprehensive study of the reactions of pain behaviors, physiological indicators of stress, and laboratory tests showed that the use of the scheme on the basis of preemptive analgesia with acetaminophen 30 mg/kg and a continuous infusion of fentanyl – 5 mg/kg/h provide effective analgesia.

Key words: analgesia, non-opioid analgesics, postoperative period.