Paracetamol and ibuprofen fixed-dose combination for the management of acute mild-to-moderate pain in children: strengthening and enhancing of result of Nominal Group Technique through Delphi consensus.

Autor: Castagno E; Department of Pediatric Emergency, Regina Margherita Children's Hospital, Turin, Italy., Parri N; Department of Emergency Medicine and Trauma Center, Meyer Children's Hospital IRCCS, Florence, Italy. niccolo.parri@meyer.it., D'Avino A; National Health Care Service, President of Federazione Italiana Medici Pediatri FIMP, Naples, Italy., Ferrari E; National Health Care Service, Federazione Italiana Medici Pediatri FIMP, Reggio Emilia, Italy., Marchisio PG; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.; Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Messia V; Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy., Taglialatela M; Division of Pharmacology, Department of Neuroscience, University of Naples Federico II, Naples, Italy., Staiano A; Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy.; President of the Italian Society for Pediatrics (SIP), Rome, Italy.
Jazyk: angličtina
Zdroj: Italian journal of pediatrics [Ital J Pediatr] 2024 Oct 29; Vol. 50 (1), pp. 223. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1186/s13052-024-01791-x
Abstrakt: Background: Paracetamol and ibuprofen are the most commonly used drugs for pain treatment in children and their combination has shown improved analgesic effect compared to treatment with either drug alone. Current literature lacks specific guidelines regarding the settings in which this combination should be adopted.
Methods: The survey, conducted with Delphi methodology, involved 75 hospital and outpatient pediatricians with clinical experience in the management of pain in children. Pediatricians involved were asked to validate or not the results of the previous NominalGroup Tecnique (NGT) consensus and thus specify the optimal clinical settings in which the paracetamol/ibuprofen fixed-dose combination could be adopted.
Results: The results confirm the importance of the fixed-dose paracetamol and ibuprofen combination for the control of mild-to-moderate acute pain in children. Particularly, this association seems to be appropriate in case of headache, earache, odontalgia and musculoskeletal pain, and in specific settings such as post-operative and post-procedural pain. The broadening of the panel brought to slight variations in clinical management practices between hospital and outpatient specialists. Nonetheless, overall consensus supports the notion that the fixed dose combination is more efficacious than monotherapies and it is well tolerated. Moreover, experts unanimously agree on the usefulness of the combination for caregivers, leading to improved adherence and effectiveness.
Conclusions: Both the NGT consensus and the broader Delphi consensus confirm the usefulness of the paracetamol-ibuprofen fixed-dose combination in pediatric pain. This is attributed to its superior effectiveness compared to monotherapies, a good tolerability profile, and improved compliance and ease of use. Some pain settings related to chronic, inflammatory and rheumatological pathologies remain to be investigated to evaluate the use of this combination.
(© 2024. The Author(s).)
Databáze: MEDLINE
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