Current Content
Volume 43 - Number 4
July/August 2017

Effect of Rectal Acetaminophen with Intravenous Opioid on Comfort Levels and Opioid Use in Full-Term Infants Post-Open Heart Repair
Jacqueline M. Ochsenreither, E. Zachary Ramsey, Carol G. Mest, and Theresa DiMaggio

Pediatric cardiothoracic surgical patients experience varying degrees of pain in the immediate postoperative period. Multiple analgesic modalities can be used to effectively manage pain in this patient population. Routinely, intravenous (IV) opioid is prescribed postoperatively to manage acute pain needs in this select group of patients. Rectal acetaminophen as an adjunct to IV opioid to improve comfort levels and decrease overall opioid use in the immediate postoperative period in this specific pediatric population has not been examined. This retrospective study was designed to compare comfort levels and overall opioid use in full-term infants with congenital heart disease within 24 hours or less post-open heart repair. A total of 74 infants out of 203 participants who met inclusion criteria were compared. Fiftythree infants received rectal acetaminophen in conjunction with IV opioid, and 21 infants received IV opioid only. Infants prescribed rectal acetaminophen in conjunction with IV opioid had no significant difference in comfort levels as compared to infants who received IV opioid only (p < 0.08), but had a statistically significant (p < 0.01) decrease in overall opioid exposure (0.11 mg/kg/day) as compared to infants prescribed IV opioid alone (0.28 mg/kg/day).