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Analgesic interaction between ondansetron and acetaminophen after tonsillectomy in children: The P aratron randomized, controlled trial
Ist Teil von
European journal of pain, 2015-05, Vol.19 (5), p.661-668
Erscheinungsjahr
2015
Quelle
Wiley-Blackwell Journals
Beschreibungen/Notizen
Abstract
Background
The mechanism of action of acetaminophen remains unclear. One hypothesis involves an interaction with the serotoninergic system. Antagonists to serotonin (5‐
HT
)
3
receptors (setrons) have antiemetic properties. Therefore, co‐administration of acetaminophen and a setron could lead to a decrease or a loss of acetaminophen analgesic effects. The aim of this study was to demonstrate such an interaction.
Methods
P
aratron
is a prospective, randomized, controlled, double‐blind, parallel group trial. All children aged 2–7 years (
n
= 69) scheduled for a tonsillectomy ± adenoidectomy received intraoperative acetaminophen with ondansetron or droperidol. Pain scores [Children's Hospital of Eastern Ontario Pain Scale (
CHEOPS
)], morphine consumption and the incidence of post‐operative nausea and vomiting (
PONV
) were measured for 24 h following surgery.
Results
Pain scores were not different at all times between the groups but median morphine consumption (μg) in recovery was 322.5 [interquartile range (
IQR
) 0.0–500.0] and 0 (
IQR
0‐0) in the ondansetron (
n
= 35) and droperidol (
n
= 34) groups, respectively (
p
= 0.004). The percentages of patients who received morphine titration were 57.1% and 20.6% in the ondansetron and droperidol groups, respectively (
p
= 0.008). No significant difference was found for
PONV
.
Conclusions
An interaction between acetaminophen and ondansetron is suggested, with children receiving three times more morphine during pain titration in the recovery room. More studies are necessary to evaluate whether this finding is clinically relevant enough to preclude the simultaneous perioperative administration of both drugs in the future.
Sprache
Englisch
Identifikatoren
ISSN: 1090-3801
eISSN: 1532-2149
DOI: 10.1002/ejp.587
Titel-ID: cdi_crossref_primary_10_1002_ejp_587
Format
–
Weiterführende Literatur
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