Pediatric anesthesia & critical care
Intermittent intravenous paracetamol versus continuous morphine in infants undergoing cardiothoracic surgery: a multi-center randomized controlled trial
Authors' conclusion
In children aged 0-3 years undergoing cardiac surgery, use of intermittent IV paracetamol reduces the median weight-adjusted cumulative morphine consumption in the first 48 h after surgery by 79% with equal pain relief showing equipoise for IV paracetamol as primary analgesic.
Study context
- Population
- Children aged 0–3 years undergoing cardiac surgery with CPB, four level-3 Pediatric Intensive Care Units (PICUs) in the Netherlands and Belgium194 analysed
- Participants
- 208 children
- Comparison
- Intravenous (IV) paracetamol vs Morphine
- IV paracetamoln = 102
- Morphinen = 106reference
- Primary endpoint
- Median weight-adjusted cumulative morphine dose (mcg/kg)
- Follow-up
- First 48 h postoperative
Methodological detailsmulticentre, double-blinded
- Multicentre
- Double-blinded
Primary result
As reported in the abstract
P < 0.001
Further findings
| Outcome | Difference in proportion (95% CI) | P value |
|---|---|---|
| Rescue morphine consumption | P = 0.38 | |
| Proportion with ≥1 NRS pain score of 4 and higher (non-inferiority)Non-inferiority proven | - 3.1% (- 16.6-10.3%) |
- Proportion with ≥1 numeric rating scale (NRS) pain score of 4 and higher (non-inferiority): non-inferiority margin of 20%
Rescue morphine consumption
- Similar between the groups
Original publication
Intermittent intravenous paracetamol versus continuous morphine in infants undergoing cardiothoracic surgery: a multi-center randomized controlled trial. Crit Care. Published 30 April 2024. doi:10.
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