Acetaminophen Cuts Post-Op Morphine Use in Infants

Significant reduction in morphine requirements over 48 hours after major surgery

WEDNESDAY, Jan. 9 (HealthDay News) -- For infants undergoing major surgery, intermittent use of intravenous acetaminophen is associated with a significant reduction in morphine requirements over 48 hours, according to a study published in the Jan. 9 issue of the Journal of the American Medical Association.

Ilse Ceelie, M.D., Ph.D., from the Erasmus MC-Sophia Children's Hospital in Rotterdam, Netherlands, and colleagues conducted a randomized trial in three pediatric intensive care units in Rotterdam to examine whether intravenous acetaminophen would significantly reduce morphine requirements in infants and neonates after major surgery. All infants undergoing major thoracic (non-cardiac) or abdominal surgery received a loading dose of morphine before the end of surgery, followed by continuous morphine (38 infants) or intermittent intravenous acetaminophen (33 infants) up to 48 hours post-surgery.

In the first 48 hours post-surgery, the researchers found that the cumulative mean morphine dose was significantly lower (66 percent) in the acetaminophen group (121 versus 357 µg/kg). There was no significant difference in pain scores and adverse effects between the groups.

"In conclusion, among infants undergoing major surgery, postoperative use of intermittent intravenous paracetamol [acetaminophen] compared with continuous morphine resulted in a lower cumulative morphine dose over 48 hours," the authors write.

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