Paracetamol (acetaminophen) for chronic non-cancer pain in children and adolescents

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dc.contributor.author Cooper, TE en
dc.contributor.author Fisher, E en
dc.contributor.author Anderson, Brian en
dc.contributor.author Wilkinson, NMR en
dc.contributor.author Williams, DG en
dc.contributor.author Eccleston, C en
dc.date.accessioned 2017-12-20T22:50:42Z en
dc.date.issued 2017-08-04 en
dc.identifier.citation Cochrane Database of Systematic Reviews (8), CD012539. 2017 en
dc.identifier.issn 1469-493X en
dc.identifier.uri http://hdl.handle.net/2292/36809 en
dc.description.abstract Background Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. TheWorld Health Organization guidelines for pharmacological treatments for children’s persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children’s pain have changed over time, and relief of pain is now seen as important. We designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, nonsteroidal anti-inflammatory drugs, opioids, and paracetamol as priority areas) in order to review the evidence for children’s pain utilising pharmacological interventions in children and adolescents. As the leading cause of morbidity in children and adolescents in the world today, chronic disease (and its associated pain) is a major health concern. Chronic pain (lasting three months or longer) can arise in the paediatric population in a variety of pathophysiological classifications: nociceptive, neuropathic, idiopathic, visceral, nerve damage pain, chronic musculoskeletal pain, and chronic abdominal pain, and other unknown reasons. Paracetamol (acetaminophen) is one of the most widely used analgesics in both adults and children. The recommended dosage in the UK, Europe, Australia, and the USA for children and adolescents is generally 10 to 15 mg/kg every four to six hours, with specific age ranges from 60 mg (6 to 12 months old) up to 500 to 1000 mg (over 12 years old). Paracetamol is the only recommended analgesic for children under 3 months of age. Paracetamol has been proven to be safe in appropriate and controlled dosages, however potential adverse effects of paracetamol if overdosed or overused in children include liver and kidney failure. Objectives To assess the analgesic efficacy and adverse events of paracetamol (acetaminophen) used to treat chronic non-cancer pain in children and adolescents aged between birth and 17 years, in any setting. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of StudiesOnline,MEDLINE via Ovid, and Embase via Ovid from inception to 6 September 2016. We also searched the reference lists of retrieved studies and reviews, and searched online clinical trial registries. Selection criteria Randomised controlled trials, with or without blinding, of any dose and any route, treating chronic non-cancer pain in children and adolescents, comparing paracetamol with placebo or an active comparator. Data collection and analysis Two review authors independently assessed studies for eligibility. We planned to use dichotomous data to calculate risk ratio and numbers needed to treat, using standard methods where data were available. We assessed GRADE (Grading of Recommendations Assessment, Development and Evaluation) and planned to create a ’Summary of findings’ table. Main results No studies were eligible for inclusion in this review. We rated the quality of the evidence as very low. We downgraded the quality of evidence by three levels due to the lack of data reported for any outcome. Authors’ conclusions There was no evidence from randomised controlled trials to support or refute the use of paracetamol (acetaminophen) to treat chronic non-cancer pain in children and adolescents. We are unable to comment about efficacy or harm from the use of paracetamol to treat chronic non-cancer pain in children and adolescents. We know from adult randomised controlled trials that paracetamol, can be effective, in certain doses, and in certain pain conditions (not always chronic). This means that no conclusions could be made about efficacy or harm in the use of paracetamol (acetaminophen) to treat chronic noncancer pain in children and adolescents. en
dc.publisher Cochrane Collaboration en
dc.relation.ispartofseries Cochrane Database of Systematic Reviews en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. details obtained from http://www.sherpa.ac.uk/romeo/issn/1469-493X/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Paracetamol (acetaminophen) for chronic non-cancer pain in children and adolescents en
dc.type Journal Article en
dc.identifier.doi 10.1002/14651858.CD012539.pub2 en
pubs.issue 8 en
dc.description.version VoR - Version of Record en
dc.rights.holder Copyright: The authors en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Review en
pubs.elements-id 645509 en
pubs.org-id Faculty of Medical & Hlth Sci en
pubs.org-id School of Medicine en
pubs.org-id Anaesthesiology en
dc.identifier.eissn 1469-493X en
pubs.number CD012539 en
pubs.record-created-at-source-date 2017-08-08 en
pubs.online-publication-date 2017-08-04 en


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