1. Effect of parenteral acetaminophen on the
attenuation of post-operative pain subsequent colectomy. A
randomized, double-blind clinical trial.
Eilyad Issabeagloo, Babak Abri Aghdam, Ali Rezaei, Department of
Pharmacology, Islamic Azad University, Tabriza, Iran. Life Sci J
2013;10(4s):308-313
Abstract: Analgesic efficacy of parenteral acetaminophen
is variable in different surgical procedures. Little data is
available on its efficacy in colectomy. Intravenous Acetaminophen
is a useful drug in treating postoperative pains and could be
used alone or in combination with other drugs. Current study
conducted this prospective, randomized, double blind study to
evaluate and compare the efficacy acetaminophen (AEKNIL) with
morphine in colectomy surgery over a 24 hour period. Methods: In
a clinical trial, 79 patients candidate for elective lumbar
colectomy were randomly put into groups receiving Acetaminophen
(40 patients) or placebo (39 patients). In group one, 1 g I.V.
Acetaminophen infusion was started 15 minutes before the end of
surgery. Group 2 received 100 ml NaCl 0.9% in the same period.
Pain scores were assessed at relaxation with VAS (visual analogue
scale) at 0 (after awakening), 5, 10, 15 and 24 hours. Morphine
use (according to patient's will due to pain) was recorded in
24 hours. Results: Acetaminophen group had significantly lower
mean VAS (less severe pain) than placebo group after recovery
(5.73±1.89 versus 6.85±2.11, p=0.004), 5 hours later (5.34±2.03
versus 7.67±1.9, p=0.01), 10 hours later (4.81±1.29 versus
5.71±1.31, p=0.02), 15 hours later (4.11±1.05 versus 4.67±1.61,
p=0.02) and 24 hours later (2.61±1.31 versus 3.57±1.41, p=0.01).
Morphine requirement in different periods was lower in
Acetaminophen group than placebo which had no significant
differences. Mean cumulative morphine use in 24 hours in
Paracetamol group (5.89±2.79 mg) was lower than placebo group
(8.48±3.51 mg), however the difference was not significant.
Conclusion: Results of current study showed that intravenous
Acetaminophen is effective in reducing postoperative pain
severity, but does not reduce need for morphine use.
2. Analgesic efficacy of AEKNIL (Paracetamol) Injection in
immediate post-episiotomy/perineal tear pain
management.
Dr.I.A.Sotande, Prof. S.D. Amanor-Boadu, Dr. I.G. Ismaila, Dr. O.
Olasore, Oba Ademola Maternity Centre, Nigeria. OAMCJ 2002.
Abstract: To determine the analgesic efficacy of AEKNIL
(Paracetamol) injection for immediate post-episiotomy / perineal
tear pain relief in parturient women. Methods: One hundred women
who gave birth vaginally and had episiotomy or perineal tear were
included in the study. Discussion: Group A received intramuscular
acetaminophen (AEKNIL) in addition to xylocaine infiltration of
the episiotomy / perineal tear wound before the repair of the
wound. Group B received intramuscular injection of Aqua in
addition to xylocaine infiltration of the episiotomy / perineal
wound before the repair of the wound. After the repair patients
were transferred to ward for monitoring of the vital signs and
pain assessment. The pain assessment was done every 15 minutes
for 4 hours by the research assistant using 10cm visual analog
scale. The times of first analgesic requirement were noted and
patients were monitored for any complications. Conclusion: The
results obtained demonstrate that AEKNIL (Paracetamol) injection
has a clear analgesic effect post-episiotomy/perineal tear repair
demonstrated by longer time to first analgesic requirement.
3. Use of N-acetylparaaminophenol (Paracetamol) in
parenteral form in pediatrics.
Dr.Versha Modi, Dr. A.B.Desai, Department of Pediatrics,
B.J.Medical College and Civil Hospital, Ahmedabad, Gujarat,
India, Pediatric Clinics of India, July 1974.
Abstract: In this clinical trial, N-Acetyl Para
Aminophenol (Paracetamol AEKNIL) was used in the Injectable form
mainly to note its antipyretic effects in small children.
Methods: Any child in the pediatric ward with temperature above
101°F was taken for study. The children of all age groups
including newborn babies were considered for the trial. The cases
were alternately given Injection of Analgin or if pyrexia
recurred they were given the two antipyretics alternately.
Immediately before and after the Injection was given, the
temperature of the patient was recorded both per rectum and in
the axilla for 2 minutes with standardised thermometers. The
temperature was recorded every half-hour, till the temperature
came to below 98F for at least 4 hours. Any side effects like
appearance of cyanosis, dyspnoea, weakness or signs of vascular
and respiratory collapse were watched for and recorded. The time
required to reduce pyrexia was noted. If the pyrexia recurred,
the interval was noted and any untoward effects were observed and
recorded. The dose of N-Acetyl Para Aminophenol (Paracetamol) is
0.3 to 0.6 gm/dose. In children the usual practice is to give 60
mg per each year of age till the maximum is reached. Injection
N-Acetyl Para Aminophenol (Paracetamol) contains 150 mg/ml. The
drug was used in the following schedule: 0.25 ml/dose up to 1
year of age; 0.5 ml/dose from 1 to 2 year of age; 1 ml dose for 3
to 4 years of age; 2 ml dose above 10 years of age. Injection
N-Acetyl Para Aminophenol (Paracetamol) was used on 75 occasions
in recommended dose. Injection Analgin was used on 50 occasions.
Twelve observations when oral antipyretic was administered are
also included. The results were graded as Good, Fair, and Poor.
Results: The response was good, i.e., the temperature could be
lowered to normal within half to 1 hour and the results were
identical in both injectable forms. In 89.3% of cases, the
response in lowering the temperature was satisfactory. The
temperature was brought to normal within 2 hours. Oral
administration has been useful in only 50% of the cases. No toxic
reactions were encountered in any of these patients either in
injectable or oral therapy. Considering the good and the fair
response almost in 90% of the cases, the temperature could be
brought down to normal within 2 hours. Here also the Injectable
forms were equally effective. In the last group where the
response was poor, all the cases were of specific diseases like
Tetanus, Tuberculosis and Enteric Fever where the temperature
could be brought down by 2°F or 3°F but did not touch normal.
Conclusion: N-Acetyl Para Aminophenol (Paracetamol) is a very
safe drug when given intramuscularly. It can be given safely to
all age groups including newborn babies. In all types of
illnesses, specific or nonspecific, it is very useful in lowering
the temperature to normal within a short time. Even when the
temperature did not touch normal, it was lowered by 2°F to 3°F,
which brings about considerable relief and comfort to the
patients. It is not toxic can be safely used. No local pain was
complained of by older children.
4. Therapy of fever with special reference to Paracetamol:
A clinical trial.
Dr.Manoranjan Sahai, Department of Pediatrics, Darbhanga Medical
College, Laheria Sarai, Bihar, India. DMCJ 1972
Abstract: The aim of this clinical trial is to study the
effect of Paracetamol (AEKNIL) on pyrexia. The dose for the
antipyretic and analgesic effect of AEKNIL used was 3mg/kg of
body weight. The route of administration of the drug was oral and
by Injection. Methodology: 60 patients were enlisted in the
trial. The effect of the drug in various ranges of pyrexia were
observed and the results tabulated as Good (temperature is
reduced by 3 to 4°F within 8 to 12 hours of administration of
drug.), Fair (temperature was reduced at least by 2°F within 4 to
8 hours of the administration of drug.) and Poor (No reduction in
pyrexia after 48 hours treatment.) Discussion: Temperature
reduced by 3 to 4°F within 8 to 12 hours of administration of
drug in 30 cases. Temperature reduced at least by 2°F within 4 to
8 hours of the administration of drug in others. Conclusion: From
the observations done in the Department of Pediatrics, Darbhanga
Medical College, Laheria Sarai, Bihar, with AEKNIL Drops and
Injection (Paracetamol) under the guidance of Prof. B.N Das
Gupta,Professor and Head of the Department of Pediatrics, we
conclude that AEKNIL is of considerable value when used as an
antipyretic, analgesic drug.
5. Clinical trial with AEKNIL brand of
Paracetamol.
Dr.Lohe, Dr. Deshpande, G.T. Hospital, Bombay, India, The Bombay
Hospital Journal. Vol. 9, No. 3, July 1967.
Abstract: A clinical trial was carried out in
Children's Ward at G.T Hospital, Bombay to study the role of
"AEKNIL" as an antipyretic. For control studies, other
antipyretics viz., A.P.C Powder and 'Mist Diaphoretic"
were used. Three hundred and sixty cases were studied over a
period of one year. The cases were divided into three groups as
follows: Group 1 included 120 cases treated with
"AEKNIL" Group 2 included 120 cases treated with
"A.P.C" Group 3 included 120 cases treated with
"Mist Diaphoretic". The main aim of the trial was to
study the effect of "AEKNIL" in controlling pyrexia
irrespective of its etiology. It was used only for symptomatic
relief. Specific treatment with antibiotics was given as
required. The dosage of the antipyretic used in this trial was 2
mg/kg (Body weight below 10 kg). The antipyretic was administered
for 2 to 5 days and the results tabulated. No serious side
effects due to AEKNIL were noted in this trial. No cyanosis due
to methaemoglobinemia was seen on any occasion. Temperature
subsided completely or was reduced by at least 3°F within 12 to
24 hours of administering the drug in 48 cases and fever was
reduced by at least 2°F within 24 to 48 hours of administering
the drug in 60 cases. Conclusion: AEKNIL is of considerable value
when used as an antipyretic in wide range of common pediatric
ailments. The great advantage is that it is almost free from any
side effect and because of its complete miscibility in water, it
could be used both in oral and intra-muscular form.