title: Comparing the duration of the analgesic effects of intravenous and rectal acetaminophen following tonsillectomy in children.
abstract: BACKGROUND
  Postoperative pain control (especially, after adenotonsillectomy) has a very important effect on recovery time, hospitalization duration, hemodynamic disorders, bleeding, nausea, vomiting and medical costs.
  
  
  OBJECTIVE
  The aim of this study was to investigate and compare the effects of intravenous and rectal acetaminophen on controlling post-adenotonsillectomy pain in children, and duration of their analgesic effects.
  
  
  METHODS
  In this randomized double-blinded clinical trial, 96 children aged 4 - 10 years old with ASA physical status I or II who were candidates for adenotonsillectomy surgery in Amir-al-Momenin Hospital, Rasht, Iran were entered into the study and randomly divided into two equal groups. Anesthesia in both groups was induced injecting fentanyl-thiopental and at racurium; afterwards is of lurane was used to maintain anesthesia. After anesthesia induction, one group received intravenous and the other one, rectal acetaminophen, and were later compared based on CHIPPS criteria.
  
  
  RESULTS
  Data analysis indicated a significant relationship between reduction of postoperative pain and the use of intravenous or rectal acetaminophen (P = 0.0001); in group receiving IV acetaminophen, only 10.4% of patients had no pain whereas in group receiving rectal acetaminophen, this number reached 43.8%. Also, on 4 and 6 hour time intervals, pain in rectal acetaminophen receiving group was less than that in IV acetaminophen receiving group (P < 0.05). Demand for additional analgesic medication in rectal acetaminophen receiving group was less than that in IV group (P = 0.0001).
  
  
  CONCLUSIONS
  Post-operative pain in rectal acetaminophen group was less than that in intravenous acetaminophen group, and rectal acetaminophen group demanded their first additional analgesic medication later.
authors.affiliation: Anesthesia Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Soudabeh
authors.initials: S
authors.lastname: Haddadi
authors.affiliation: Anesthesia Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Shideh
authors.initials: S
authors.lastname: Marzban
authors.affiliation: Anesthesia Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Mohammad Seddigh
authors.initials: MS
authors.lastname: Karami
authors.affiliation: Anesthesia Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Abtin
authors.initials: A
authors.lastname: Heidarzadeh
authors.affiliation: Anesthesia Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Arman
authors.initials: A
authors.lastname: Parvizi
authors.affiliation: Anesthesia Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Naderi Nabi
keywords: Acetaminophen; Child, Hospitalized; Pain, Postoperative