Tepid sponging plus dipyrone versus dipyrone alone for reducing body temperature in febrile children

Abstract

CONCLUSIONS:Tepid sponging plus dipyrone cooled faster during the fi rst 15 minutes, but dipyrone alone presented better fever control over the two-hour period. Tepid sponging caused mild discomfort, crying and irritability for most of the children.KEY WORDS: Fever. Dipyrone. Child. Baths. Antipyretics. CLINICAL TRIAL REGISTRATION NUMBER:ACTRN12608000083392. 108Sao Paulo Med J. 2008;126(2):107-11.during the previous six hours were excluded, as were children with known liver or renal diseases, gastrointestinal bleeding, known allergy to dipyrone, congenital or acquired immunodeficiency or malignancy. The same room was used for all children and informed consent to participate in the trial was obtained from the parents. This study was approved by the local institutional human rights committee The children were assigned randomly by drawing a numbered envelope to receive oral dipyrone and tepid sponging (sponging group) or dipyrone only (control group). All children were given 20 mg/kg of dipyrone syrup orally at the beginning of the study procedure. The study medication was administered by staff nurses. Children assigned to receive tepid sponging were naked and sponged from head to toe (except the scalp), for 15'. The temperature of the water used ranged from 28 C to 32 C. The ambient temperature throughout the period of the study ranged from 27 C to 30 C. Axillary temperatures were the primary outcome and were recorded after 15 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes. A digital thermometer was used. If, during the course of the study, the child's body temperature increased by 0.5 C above baseline the patient was considered to be a treatment failure.It was recorded whether the child was crying, irritable or shivering before each temperature measurement. A summary profile of the study is shown in Figure 1.The sample size was calculated on the basis of 90% statistical power and an error margin of 0.05. Epi Info version 6 was used to perform the analysis. Student's t-test was used to compare the means of the axillary temperatures in each group, calculated for each observation time. The chi-squared test was used for categorical variables. A p-value of < 0.05 was used as the cutoff point for statistical significance.No pharmaceutical laboratories had any role in the study design, data collection or analysis, or writing of the paper. RESULTSDuring the six-month study period, 876 children were treated for fever in the emergency department between the hours of 5:00 and 7:00 p.m. 756 children were ineligible for the trial: 385 were unable to stay in the emergency ward for a minimum of two hours; 193 fulfilled at least one exclusion criterion, which most often consisted of having received an antipyretic within the previous six hours; and the remaining 178 did not meet the inclusion criteria. Among the 120 eligible children, all were given parental consent for enrollment in the study. Of these, 60 received dipyrone plus tepid sponging and 60 received dipyrone alone (controls). The distribution of the child...

Tepid massage for febrile children: A systematic review and meta‐analysis

“…After removal of duplicates, 1286 studies remained; 2 systematic reviews (Meremikwu & Oyo‐Ita, , ) and 14 experimental studies were selected according to the inclusion/exclusion criteria. Finally, 14 experimental studies (Agbolosu et al, ; Aksoylar et al, ; Alves et al, ; Brandts, ; Friedman & Barton, ; Hunter, ; Kang et al, ; Kinmonth, ; Lee et al, ; Mahar et al, ; Newman, ; Sharber et al, ; Steele, Tanaka, Lara, & Bass, ; Thomas et al, ) were included (Figure ).…”

“…The general characteristics of the 14 selected studies ( n = 1234) are shown in Table . While 3 studies (Alves et al, ; Lee et al, ; Thomas et al, ) were published since 2000, most studies were published before 2000 (Agbolosu et al, ; Aksoylar et al, ; Brandts, Ndjave, Grainger, & Kremsner, ; Friedman & Barton, ; Hunter, ; Kang et al, ; Kinmonth, Fulton, & Campbell, ; Mahar, 1994; Newman, ; Sharber, ; Steele et al, ). While 2 studies were conducted in the United States (Friedman & Barton, ; Sharber, ), 2 studies (Kang et al, ; Lee et al, ) were conducted in the Republic of Korea; a single study was conducted in Australia, Brazil, Canada, Gabon, Hawaii, India, Malawi, Thailand, Turkey, and the United Kingdom (Agbolosu et al, ; Aksoylar et al, ; Alves et al, ; Brandts et al, ; Hunter, ; Kinmonth et al, ; Mahar, 1994; Newman, ; Steele et al, ; Thomas et al, ).…”

“…Among 6 studies comparing the change in temperature between the combination of tepid massage and antipyretics and antipyretics alone (Alves et al, ; Kang et al, ; Lee et al, ; Mahar, 1994; Steele et al, ; Thomas et al, ), the SMD between the groups was 0.15(95% CI: 0.46 to 0.17; I 2 = 44%; P = 0.36) (Alves et al, ; Kang et al, ; Lee et al, ). On the other hand, significant differences were observed between the studies (risk ratio [RR] 11.72; 95% CI: 3.39 to 40.51; I 2 = 0%, SMD 0.63; 95% CI: 0.27 to 0.99; I 2 = 0%; P < 0.0005) (Alves et al, ; Kang et al, ; Mahar, 1994; Steele et al, ). Changes in temperature occurred in 43.3% of the combination groups ( n = 26/60) and in only 3.1% of control groups ( n = 2/65).…”

Rancang Bangun Alat Penurun Suhu Tubuh Berbasis Pada Sistem Refrigerasi Kompresi Uap

“…Kompres tepid sponge adalah sebuah teknik kompres hangat yang menggabungkan teknik kompres blok pada pembuluh darah supervisial dengan teknik seka [6].…”

Metamizole: A Review Profile of a Well-Known “Forgotten” Drug. Part II: Clinical Profile

“…crying and irritability were observed respectively in 52 % and 36 % of the sponged children and in none and only two of the controls. the authors concluded that tepid sponging plus metamizole cooled faster during the first 15 min, but metamizole alone presented better fever control over the two-hour period (4). only a few controlled clinical trials have compared metamizole with other analgesics in children.…”