Intravenous paracetamol overdose in a preterm infant during anesthesia

Nevin, Daniel; SHung, J

doi:10.1111/j.1460-9592.2009.03210.x

Cited by 35 publications

(24 citation statements)

References 3 publications

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“…One of the main concerns surounding acetaminophen is drug overdosage, which can lead to significant liver toxicity. 213 Acetaminophen has also been used for procedural pain such as immunizations or circumcision. 214 …”

Section: Non-opioid Therapiesmentioning

confidence: 99%

Pain Management in Newborns

Hall¹,

Anand

2014

Clinics in Perinatology

204

126

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Effective pain management is a desirable standard of care for preterm and term newborns and may potentially improve their clinical and neurodevelopmental outcomes. Neonatal pain should be assessed routinely using context-specific, validated and objective pain methods, despite the limitations of currently available tools. Reducing invasive procedures, and using pharmacological, behavioral or environmental measures can be used to manage neonatal pain. Non-pharmacologic approaches include kangaroo care, facilitated tucking, non-nutritive sucking, sucrose and other sweeteners, massage and acupuncture therapy. They are used for procedures causing acute, transient, or mild pain, or as adjunctive therapy for moderate or severe pain. Local and topical anesthetics can reduce the acute pain caused by skin-breaking or mucosa-injuring procedures. Opioids form the mainstay for treatment of severe pain; morphine and fentanyl are the most commonly used drugs, although other opioids are also available. Non-opioid drugs include various sedatives and anesthetic agents, mostly used as adjunctive therapy in ventilated neonates. Acetaminophen, ibuprofen and other drugs are used for neonates, although their efficacy and safety remains unproven. Approaches for implementing an effective pain management program in the Neonatal ICU are summarized, together with practical protocols for procedural, postoperative, and mechanical ventilation-associated neonatal pain and stress.

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Section: Non-opioid Therapiesmentioning

confidence: 99%

Pain Management in Newborns

Hall¹,

Anand

2014

Clinics in Perinatology

204

126

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show abstract

“…NAC appears to be safe in the neonate, and in accordance with current recommendations, it may be administered despite subtoxic serum paracetamol levels [3,9] The National Poisons Information Service has recently updated its recommendations on the management of IV paracetamol poisoning (www.toxbase.org), and it is now suggested that intervention with NAC is appropriate after a single IV dose of 60 mg/kg or repeated excess dosing of >60 mg/kg.…”

Section: Sirsmentioning

confidence: 82%

“…The use of adult nomograms for treatment decisions in overdose cases is questionable, as they are based on the shorter half-life of paracetamol in adults. Table 1 summarizes previously published reports of paracetamol overdoses in neonates [3,[6][7][8]. All report a surprising lack of toxicity, with complete clinical and biochemical recovery after treatment with NAC.…”

Section: Sirsmentioning

confidence: 90%

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Lack of toxicity after paracetamol overdose in a extremely preterm neonate

Porta

Sánchez

Nicolás

et al. 2012

Eur J Clin Pharmacol

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“…Medication errors, especially those involving tenfold dosing errors, pose a significant risk to neonates receiving intravenous paracetamol. This has been reported in both neonates and infants 7–9. It is important that one is aware of the risk of medication errors, especially in relation to a new formulation of a drug that has previously been administered by a different route.…”

Section: Safety Of Intravenous Paracetamol In Neonatesmentioning

confidence: 98%