Articles: acetaminophen.
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Randomized Controlled Trial Clinical Trial
Effect of preemptive acetaminophen on postoperative pain scores and oral fluid intake in pediatric tonsillectomy patients.
Postoperative pain is a significant problem that continues to be undertreated in the pediatric population. Preemptive administration of analgesics has recently emerged as a method to enhance pain management associated with surgery. The purpose of this study was to compare postoperative pain scores, rescue analgesic use, and oral fluid intake in children who received acetaminophen preoperatively to children who received postoperative acetaminophen. ⋯ Incidence of nausea and vomiting was high in both groups (64-78%). These results provide evidence that preemptive acetaminophen may enhance analgesia in pediatric tonsillectomy patients. Preoperative acetaminophen is a safe, quick, and inexpensive intervention that can readily be incorporated into anesthesia practice.
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The prince of Wales Hospital is in a unique position for the study of the actual incidence of acetaminophen poisoning in Hong Kong because it is the sole general teaching hospital in the New Territories East and the age and sex distribution of the population in the region are readily available. Between 1991 and 1994, the rate of admission in subjects aged > or = 15 years slightly increased from 5.7 to 7.3/100,000. In both 1991 and 1994, the highest rates in women were in the 15-19 age group (from 22.8 to 53.0/100,000) and in men in the 25-29 age group (from 10.5 to 6.0/100,000). ⋯ There were no deaths. Thus, acetaminophen poisoning appears to cause less fulminant liver failure and deaths in Hong Kong than in other Western societies. Reasons for such differences need to be better understood.
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Ugeskrift for laeger · Nov 1996
Review Practice Guideline Guideline[Recommendations for treatment of paracetamol poisoning. Danish Medical Society, Study of the Liver].
Based on recent reports concerning the efficacy of N-acetylcysteine (NAC) in paracetamol (acetaminophen) poisoning, guidelines for treatment and control of these patients are reviewed by a study group under the Danish Association for the Study of the Liver. It is recommended that NAC-treatment is initiated immediately after referral and continued for 36 hours in all cases. Further NAC-treatment should not be discontinued before a decrease in INR has been observed.
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Seminars in liver disease · Nov 1996
ReviewClassification, etiology, and considerations of outcome in acute liver failure.
Clinical descriptions of fulminant hepatic failure as originally reported, along with the subgroups of subfulminant and late onset hepatic failure identified later, are considered in relation to the proposed new classification of hyperacute, acute, and subacute liver failure. This reflects different clinical patterns of illness, etiology, and most importantly, prognosis. In addition to the defining state of encephalopathy and other manifestations directly related to the severe derangement in function and structure of the liver, the constellation of clinical symptoms and signs in acute liver failure (ALF) includes, to varying degrees, those of multiorgan failure. ⋯ Whereas hepatitis C is the major cause of ALF in Japan and the Far East, fulminant hepatitis C is seen rarely in America and European countries where most series show that in about one third of cases of presumed viral ALF, no specific agent can be identified. Over the past 10 years, the survival of those with grade 3 to 4 encephalopathy has shown a steady rise as a result of improvements in medical care, quite apart from the introduction and now widespread availability of transplantation for the treatment of this condition. As shown by a number of groups, a variety of different hematologic, biochemical, and clinical features can be used as predictive indices of the likely outcome and in determining the approach to treatment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Morphine consumption in patients receiving rectal paracetamol and diclofenac alone and in combination.
Paracetamol and diclofenac have different mechanisms of action, and the combination may be more effective than each drug used alone in treating postoperative pain. In a double-blind, controlled design, we studied 60 patients undergoing elective abdominal gynaecological surgery, who received suppositories of paracetamol 1.5 g, diclofenac 100 mg or a combination of the two before the start of surgery. ⋯ There was no difference in the incidence of morphine-related side effects between the groups. We conclude that a diclofenac-paracetamol combination reduced the amount of morphine used compared with paracetamol alone.