The Comparison of the Analgesic Effect of Intravenous Acetaminophen with Fentanyl in Thoracic and Abdominal Surgeries of Newborns

Abstract

Background The use of opioid drugs for controlling pain during and after surgery is a common but complicated procedure in neonatal anesthesia. This study compared the analgesic effect of acetaminophen with fentanyl after abdominal and chest surgery in Iranian newborns. Materials and Methods This randomized, double-blind clinical trial was conducted in two hospitals; in the NICU of Shahid Motahari hospital in Urmia and Namazi hospital in Shiraz, Iran. Sixty-six patients were randomized sequentially and assigned in two groups. One group of patients received acetaminophen dose of 10 mg/kg every six hours, and another group received fentanyl 6 µg/Kg every six hours for 48 hours (9 doses). For all patients, pain was assessed using the Neonatal Infant Pain Scale (NIPS) at first time, 6, 12, 18, 24, 30, 36, 42 and 48 hours (9 measurements). If necessary, fentanyl 1 µg/Kg was injected to the patients. Finally, all the information was recorded and analyzed using SPSS software (version 21.0). Results The mean age of the fentanyl group was 16.79 ± 15.57 days and 16.67 ± 15.77 days in the acetaminophen group (P>0.05). The mean weight in the fentanyl group was 3460 ± 737 gr and in the acetaminophen group was 3228.548 ± 32.28 gr (P>0.05). Results showed that the mean scores of pain in all periods of time were not significantly different between the two groups (P>0.05). No drug complications were seen in the acetaminophen group. Conclusion Based on the results, mean score of pain in fentanyl and acetaminophen groups was not statistically significant. Acetaminophen did not control pain as well as fentanyl in neonatal surgeries.