Intravenous Paracetamol Reduces Postoperative Morphine Requirements in Infants

Intermittent paracetamol reduced the cumulative morphine dose 66% relative to continuous morphine dosing.

Morphine is used regularly to manage pain in neonates and infants, but is associated with adverse effects including respiratory depression. In a placebo-controlled, randomized trial, investigators in the Netherlands examined whether intermittent intravenous (IV) paracetamol (acetaminophen; 30 mg/kg/day in 4 doses) reduced postoperative morphine requirements during the 48 hours following thoracic (noncardiac) or abdominal surgery in 71 neonates (birth weight, >1500 gm; age range, 36 weeks to 1 year) compared with continuous morphine infusion (2.5µg/kg/hour in infants ≤10 days or 5 µg/kg/hour in older infants).

All infants received IV morphine (100 µg/kg) 30 minutes prior to the end of surgery and rescue IV morphine when standardized pain and …

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)