The efficacy of preoperative intravenous acetaminophen for laparoscopic extraperitoneal closure in children with inguinal hernia for The enhanced recovery after surgery: A prospective randomized study

• Published in: Journal of Pediatric Surgery Open Vol. 2; p. 100022
• Main Authors: Takahashi, Toshiaki, Yamoto, Masaya, Nomura, Akiyoshi, Fukumoto, Koji, Urushihara, Naoto
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-07-2023; Elsevier
• Subjects: Acetaminophen; ERAS; LPEC; Pain management; Prospective randomized study; LPEC; Acetaminophen; Prospective randomized study; Pain management; ERAS
• ISSN: 2949-7116; 2949-7116
• DOI: 10.1016/j.yjpso.2023.100022

•In LPEC procedure, there is still postoperative pain occurring and optimal analgesia remains unclear.•Our results suggest that preoperative intravenous acetaminophen for postoperative analgesia after LPEC in children is safe and useful for the ERAS.
A postoperative pain management strategy for the enhanced recovery after surgery (ERAS) protocol has recently become more important in pediatric surgery and growing attention is being paid to perioperative use of intravenous acetaminophen (IV-A). In laparoscopic extraperitoneal closure (LPEC) procedure, postoperative pain is still occurring and optimal analgesia remains unclear. We aimed to evaluate the efficacy of preoperative IV-A (pIV-A) for postoperative analgesia after LPEC in children.
After approval of the ethics committee of our hospital (#2,018,131), 40 consecutive pediatric patients with unilateral inguinal hernia were randomized into two group (20 each) and received LPEC procedure with pIV-A (group-A) and without (group-C). The pain scale score (PSS), the frequency of the postoperative acetaminophen bolus use (FPAB) and school start day (SSD) were assessed.
The PSS and the FPAB are significantly lower in group-A compared to group-C on POD0 and POD1, indicating a significant reduction in pain in group-A at an early stage after the operation. In addition, SSD after LPEC operation was shorter in group-A compared to group-C.
Our results suggest that pIV-A for postoperative analgesia after LPEC in children is safe and useful for the ERAS.