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Clinically effective implementation of intravenous paracetamol as primary analgesia after major surgery in neonates and young infants
  1. Manuel A Baarslag1,
  2. Erwin Ista1,
  3. Tom de Leeuw2,
  4. Joost van Rosmalen3,
  5. Dick Tibboel1,
  6. Monique van Dijk1,
  7. Saskia N de Wildt1,4
  1. 1 Intensive Care and Pediatric Surgery, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam, The Netherlands
  2. 2 Department of Anesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands
  3. 3 Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
  4. 4 Department of Pharmacology and Toxicology, Radboud University, Nijmegen, The Netherlands
  1. Correspondence to Dr Manuel A Baarslag, Intensive Care and Pediatric Surgery, Erasmus Medical Center-Sophia Children’s Hospital, Rotterdam 3000 CB, The Netherlands; m.baarslag{at}

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We previously showed that intravenous paracetamol as primary analgesic after major non-cardiac (laparotomy or thoracotomy) surgery in infants <1 year of age reduces postoperative morphine consumption by 66% when compared with continuous intravenous morphine.1 Implementation of trial results is often challenging due to barriers such as low acceptance by healthcare professionals, lack of motivation and lack of awareness.2 Given the morphine-sparing effects of intravenous paracetamol we implemented intravenous paracetamol into our hospital’s clinical practice. We now present the real-life efficacy of intravenous paracetamol for this indication and adherence to the new postoperative pain protocol.

The setting for this observational study was a tertiary care paediatric intensive care unit (PICU). In our new postoperative pain protocol, starting from January 2014, intravenous paracetamol is the primary analgesic (figure …

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