Clinical Investigation Of The Postoperative Analgesia With Acetaminophen Suppositories And Ibuprofen Suppositories In Children

Objective To investigate the feasibility safety and the effect of postoperative analgesia in children with acetaminophen suppositories and Ibuprofen suppositories.To contrast the different dose of acetaminophen suppositories and Ibuprofen suppositories used in postoperative analgesia in children,to search the best and secure dose used in postoperative analgesia in children.Method All the cases are from Yanbian university affiliated hospital, selective operation(adenoidectomy) sixty cases 1-5 years old,ASAâ… -â…¡weigh 10-20kg,normal intelligence and language development.Their operation were enforced during 8:00-10:00 am.All patient were picked out exclude the ones with abnormity blood sugar,BT,CT.Elimination standard:severe heart lung liver kidney disease,coagulation disorders,especially blood platelet decreaser,alert to NSAIDs, ulcer medical record..All the children are agreed by their parents who voluntarily to enforce postoperative analgesia,the suppositories' usage and notice are told in detail before the surgery.The patients are divided into four groups randomly,each groups with 15 cases;groupâ… acetaminophen 20 mg/kg every six hours;groupâ…¡acetaminophen 40 mg/kg for the initial time then 20 mg/kg every six hours;groupâ…¢ibuprofen 5 mg/kg every six hours;groupâ…£ibuprofen 10mg/kg for the initial time then 5mg/kg every six hours;After the anesthesia before the surgery enforce the rectal suppository,then maintain two days postoperative analgesia.when we visit the patients at 1,2,4,8,12,24 and 36 hours after the operation,record MBP,HR,RP and SpO₂,undertake analgesia(FRS and CHEOPS pain scale) and clam score.Detect the patients 'blood glucose after the surgery at 1 hour and 24 hours later.Detect stress hormone hydrocortisone ACTH.Record side effect(nausea vomiting,breath), follow-up status of wound healing,time of nick take out stitches. Result(1) Compare with the analgesia pain scale result,there are significant deviation between groupâ… ,â…¡andâ…¢,â…£in postoperation 1h,2h,4h,8h,12h;In other time spot the score of groupâ…¡is lower than groupâ… ;groupâ…£is lower than groupâ…¢but no significant deviation.(2) The results of this experiment showed that the level of blood glucose were obviously increased 1 hours after operation.and then came down slowly,.24 hours after operation.They came down outstandingly but still higher than the level of preoperation.There were no statistical significances among these four groups.There was no higher than＞8.4mmol/L.(3) There were no respiratory depression and itch of skin among four groups,2 patients in groupâ… felt nausea(13.3%),in groupâ…¡,â…¢,â…£each had 1 patient who felt nausea (6.7%) no vomitting.There is one case of drowsiness in groupâ… andâ…¡,two cases in groupâ…£.(4)The results of this experiment showed that the level of cortisol and ACTH were obviously increased 4 hours after operation,and then came down slowly,.24 hours after operation.They came down outstandingly but still higher than the level of preoperation.There were no statistical significances among these four groups.This indicated that postoperative analgesia can efficiently restrain the stress response of operation.(5) There was no infection of incisional wound and defer to take out stitches in all patients.Conclusion 1.Ibuprofen,acetaminophen which used as postoperative analgesia is effective,reduce postoperative pain in children.2.Recommend to use the first loading dose.