AbstractsMedical & Health Science

Introduction Despite the fact that many analgesics and sedatives are available, pain management in neonates is still a problem because many drugs have not been studied in neonates or show side effects that cannot be risked in infants at such an early stage of life. Paracetamol also known as acetaminophen is a widely used analgesic and antipyretic and is one of the medicines most frequently sold over the counter. It has been studied in adults and older children but a generalization about the effectiveness as an analgesic and antipyretic in neonates is not appropriate because a change in the pharmacokinetics of paracetamol in neonates, infants and children has been observed. Acetaminophens effectiveness or lack thereof as an analgesic in neonates and small infants has been the topic of several studies over the past 20 years and has attracted even more discussion lately. Still there is no clear evidence concerning the effectiveness in neonates when applied in different ways. Therefore the AIM of this assignment was to search for trials that match that exact topic. In this context each trial was evaluated and the ones that entered a power analysis were selected. Based on this a statement about the actual state of research can be made. Methods This dissertation is a systematic review. Trials were found through searches in Medline, EMBASE, Cochrane Central and Cochrane Database. Matching trials were identified through inclusion and exclusion criteria. They were reviewed and evaluated based on the Critical Appraisal Skills Programme from Guyatt et al. and scored using the Jadad scale. Results After the study selection process of identification, screening, and eligibility, 14 trials that matched the topic were found. Out if the 14 trials 6 were excluded for different reasons so that in the end, 8 published trials could be included in the systematic review calculations. From the 8 studies included in the power analysis only Nursing Child Assessment Feeding Scale (NCAFS) from the trial by Macke et al. resulted in a statistical power of ≥ 80%. Conclusion The results of the power calculations indicate that the null hypothesis regarding the pain reduction effect of acetaminophen in neonates is true. In other words the alternative hypothesis could not be supported by the power calculations made. Therefore, based on the statistical power calculations it can be said that the pain reduction effect of orally and rectally administered acetaminophen in neonates in the dosages administered in the trials, if there is any effect at all, is extremely small. Einleitung Auch bei der Vielzahl heute verfügbarer Analgetika und Sedativa stellt die Schmerzbehandlung von Neugeborenen immer noch ein Problem dar, weil viele Medikamente an Neonaten noch nicht getestet wurden oder Nebenwirkungen zeigen, die man nicht riskieren will. Paracetamol, im angloamerikanischen Raum auch bekannt als Acetaminophen, ist ein weit verbreitetes Analgetikum und Antipyretikum und eines der meist benutzten freiverkäuflichen Medikamente. Es ist an…