Dolor local durante la administración de paracetamol endovenoso que tiene como excipiente ácido acético / Local pain during the administration of intravenous paracetamol with acetic acid as excipient

Objetivo: evaluar la presencia de dolor local durante la administración endovenosa de paracetamol con ácido acético respecto a la administración de paracetamol sin ácido acético en los pacientes intervenidos en el bloque quirúrgico.Métodos: se realizó un ensayo clínico controlado aleatorizado doble ciego de dos grupos. Se incluyeron los pacientes mayores de edad intervenidos en el bloque quirúrgico de la Fundació Salut Empordà (Girona, España) durante los meses de agosto a noviembre de 2020, que precisaron administración de paracetamol endovenoso. Se requerían 60 pacientes por grupo (paracetamol con acetato frente a paracetamol sin acetato). Se recogieron variables sociodemográficas, relativas al catéter venoso, tratamiento, presencia de dolor y momento, valoración del dolor según escala numérica verbal (0 sin dolor a 10 peor dolor imaginable). Análisis descriptivo y bivariado. Comparación de grupos según el protocolo asignado.Resultados: se incluyeron 60 pacientes en cada grupo. La media de edad fue de 56,6 años (DE=15,6), el 56,7% fue varón. Los grupos fueron homogéneos y comparables en el momento basal. Se identificó presencia de dolor en el 48,3% (n= 29) de los pacientes del grupo de infusión de paracetamol con ácido acético, mientras que en el grupo sin acetato no se dio ningún caso de dolor (p< 0,001).Conclusiones: se observaron diferencias estadísticamente significativas entre el grupo de pacientes intervenidos del bloque quirúrgico a los que se les administró paracetamol sin ácido acético, que no presentaron dolor, frente al grupo de paracetamol con ácido acético, con presencia de dolor casi en la mitad de los pacientes.(AU)

Objective: to evaluate the presence of local pain during the intravenous administration of paracetamol with acetic acid compared with the administration of paracetamol without acetic acid in patients undergoing a procedure in the surgical unit.Methods: a double-blind randomized controlled clinical trial was conducted on two groups. All patients of age who underwent a procedure in the surgical unit of the Fundació Salut Empordà (Girona, Spain) from August to November 2020 and who needed the administration of intravenous paracetamol were included in the study. Sixty (60) patients were required per group (paracetamol with acetate vs. paracetamol without acetate). Sociodemographic variables were collected, as well as those related to the venous catheter, treatment, presence and time of pain, pain assessment according to the verbal numerical scale (from 0=no pain to 10=the worst pain imaginable). Descriptive and bivariate analysis. Comparison between arms according to the assigned protocol.Results: sixty (60) patients were included in each arm. Their mean age was 56.6 years (SD =15.6), and 56.7% were male. Arms were homogeneous and comparable at baseline. The presence of pain was detected in 48.3% (n= 29) of patients in the group receiving infusion of paracetamol with acetic acid, while there were no cases of pain in the group without acetate (p< 0.001).Conclusions: statistically significant differences were observed between the group of patients undergoing procedures in the surgical unit who were administered paracetamol without acetic acid, who did not present pain, vs. the group receiving paracetamol with acetic acid, where pain was present in almost half of the patients.(AU)

Weight-adapted fixed-dose combined adult antiretroviral tablets for HIV-infected children.

WHAT IS KNOWN AND OBJECTIVE: Therapeutic alternatives to simplify antiretroviral therapy (ART) in HIV-infected children are needed. We report our experience with abacavir(ABC)/lamivudine(3TC) individualized dose compounded capsules (IDCC). COMMENT: We present a prospective case series of HIV-infected children who did not weigh enough to receive the adult fixed-dose combination including ABC/3TC 600mg/300mg, and were treated with weight-adapted ABC/3TC IDCC in Barcelona, Spain. Thirteen patients (12 girls) received ABC/3TC IDCC for a median(IQR) time of 30(17-54) months. No significant changes were observed in CD4 cell counts, weight or height z-scores over time. Suppression of viral replication was maintained in 7 patients with undetectable viremia at baseline. Another 5 patients achieved viral suppression with ABC/3TC IDCC-based ART, while one non-adherent girl did not. No adverse events related to ABC/3TC IDCC were observed. WHAT IS NEW AND CONCLUSION: Despite small numbers, the long-term use of ABC/3TC IDCC was feasible, safe, and effective in the treatment of HIV-infected children.