{
  "abstract": "Purpose: Children undergoing Osteotomy correction surgery can experience substantial postoperative pain and frequently require opioids. We evaluated whether a single preincision dose of intravenous acetaminophen, added to a standardized multimodal analgesic regimen, reduces postoperative pain and perioperative opioid requirements.\n\nPatients and Methods: In this prospective, randomized, double-blind, placebo-controlled trial, 96 children aged 6–18 years undergoing elective lower-limb osteotomy correction surgery were randomized 1:1 to intravenous acetaminophen 15 mg/kg or volume-matched 0.9% sodium chloride administered 30 minutes before skin incision. The primary outcome was the incidence of moderate-to-severe pain within 72 hours after surgery, defined as a Face, Legs, Activity, Cry, Consolability (FLACC) score ≥4 at any scheduled assessment. The primary analysis used the modified intention-to-treat (mITT) population (n=95; 48 acetaminophen, 47 placebo). Secondary outcomes included perioperative opioid consumption, pain intensity, rescue analgesia, patient-controlled intravenous analgesia use, subjective sleep quality, and adverse events. The trial was prospectively registered (ChiCTR2500095363; January 6, 2025).\n\nResults: Moderate-to-severe pain occurred in 8/48 (16.7%) versus 21/47 (44.7%) children, an absolute risk reduction of 28.0% (RR, 0.37; 95% CI, 0.2–0.8; P=0.004). Intraoperative remifentanil consumption was lower in the acetaminophen group (median, 0.8 vs 1.3 mg; between-group difference, 0.6 mg; 95% CI, 0.3–0.9; P<0.001). Postoperative 72-hour morphine-equivalent consumption was also lower (median, 90.0 vs 105.0 mg; difference, 14.4 mg; 95% CI, 2.7–26.5; P=0.018). Longitudinal ordinal GEE demonstrated significant group-by-time interactions for FLACC scores both at rest (P<0.001) and during movement (P=0.002), with the analgesic benefit concentrated in the early postoperative period. Subjective sleep NRS scores were lower in the acetaminophen group on POD1 (Holm-adjusted P=0.005), although the overall group-by-time interaction was not significant (P=0.411). No increase in perioperative adverse events was observed in the acetaminophen group.\n\nConclusion: Preincision intravenous acetaminophen was associated with a lower incidence of moderate-to-severe postoperative pain and reduced opioid requirements in children undergoing osteotomy correction surgery. Larger multicenter trials are warranted to confirm these findings.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, People’s Republic of China"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lei Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Lei Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Zhu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhen Du",
      "orcid": "0000-0002-2688-6538"
    },
    {
      "affs": [
        0
      ],
      "name": "Ting Xiao"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuangquan Qu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0bs84frpc5wf1.bib",
  "cited_by": 0,
  "doi": "10.2147/dddt.s655651",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731774/",
  "id": "0bs84frpc5wf1",
  "issns": [
    "1177-8881"
  ],
  "landing_url": "https://doi.org/10.2147/dddt.s655651",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Trial Report"
    ],
    [
      "openalex",
      "2703|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7224863588",
  "pdf_url": "https://www.dovepress.com/article/download/121622",
  "pmcid": "PMC13731774",
  "pmid": "42984730",
  "published": "2026-10-30",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/0bs84frpc5wf1.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:54Z",
      "native_id": "PMC13731774",
      "source": "pmc",
      "url": "https://doi.org/10.2147/dddt.s655651"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2703|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Effect of Intravenous Acetaminophen on Preemptive Multimodal Analgesia for Pediatric Osteotomy Correction Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial",
  "title_text": "Effect of Intravenous Acetaminophen on Preemptive Multimodal Analgesia for Pediatric Osteotomy Correction Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:54Z",
  "url": "https://research.draconitic.com/paper/0bs84frpc5wf1",
  "venue": "Drug Design, Development and Therapy",
  "versions": []
}