Efficacy and safety (analgesia/adjunct to post-operative analgesia)

A systematic review of nine studies reported comparisons in 728 infants of paracetamol versus placebo or other pain-reducing interventions.⁶ Paracetamol for heel lance did not reduce pain when compared with water, cherry elixir or EMLA cream. Paracetamol use was associated with a stronger response to pain than was seen with glucose. Paracetamol did not reduce pain in infants exposed to vacuum extraction or forceps at birth and their response to a subsequent heel lance at two to three days of life was increased compared with placebo. For eye examination, paracetamol was effective in reducing pain compared with water in one study, but the pain response was stronger among paracetamol-treated infants than in infants given 24% sucrose. In infants treated with paracetamol (30 mg/kg/day) and morphine compared with morphine alone, the total amount of morphine required during the first 48 hours following major surgery to the chest or the abdomen was less in the paracetamol group.