{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T05:48:12Z","timestamp":1782193692832,"version":"3.54.5"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the analgesic efficacy and safety of pre-induction intravenous acetaminophen in preschool children undergoing day-case adenotonsillectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, randomized, double-blind, placebo-controlled trial was conducted in 80 children aged 3\u20136 years. Participants received 15\u2005mg\/kg intravenous acetaminophen or saline 15\u2005min prior to anesthetic induction. The primary outcome was FLACC pain score at 1\u2005h post-extubation. Secondary outcomes included FLACC scores at other postoperative time points, PAED emergence delirium scores, PACU opioid rescue rates, home analgesia use, and adverse events within 24\u2005h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 1\u2005h post-extubation, FLACC scores were significantly lower in the acetaminophen group [median difference \u22121.0, 95% CI \u22122.0 to \u22121.0;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002]. PACU opioid rescue rates were reduced (20.0% vs. 45.0%; absolute risk difference \u221225%, 95% CI \u221244.6 to \u22125.4%; RR\u2009=\u20090.44; NNT\u2009=\u20093.3). No significant differences were observed in PAED scores, home analgesia use, or 24-hour adverse events. Early postoperative analgesic benefit was time-limited, with no significant differences at 4, 8, or 24\u2005h postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre-induction intravenous acetaminophen effectively reduces early postoperative pain and PACU opioid requirements without increasing adverse events in preschool children undergoing day-case adenotonsillectomy. Emergence delirium was unaffected in this low-risk population. The findings support its use as a foundational component of multimodal analgesia strategies in pediatric day-case adenotonsillectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/showproj.html?proj=213700<\/jats:ext-link>\n                      , ChiCTR2400079538.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1844038","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T05:27:09Z","timestamp":1782192429000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Seeking a viable perioperative preemptive analgesia regimen: a prospective, randomized, controlled, double-blind superiority study of intravenous acetaminophen in children undergoing adenotonsillectomy"],"prefix":"10.3389","volume":"14","author":[{"given":"Zugang","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Shenzhen Children's Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runxin","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shenzhen Children's Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianyi","family":"Qiu","sequence":"additional","affiliation":[{"name":"Health Science Center, Shenzhen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyi","family":"Li","sequence":"additional","affiliation":[{"name":"School of Medicine, Southern University of Science and Technology","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyan","family":"Gan","sequence":"additional","affiliation":[{"name":"School of Medicine, Southern University of Science and Technology","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[{"name":"School of Medicine, Southern University of Science and Technology","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shenzhen Children's Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.otc.2024.02.025","article-title":"Adenotonsillectomy for obstructive sleep apnea in children","volume":"57","author":"Jaensch","year":"2024","journal-title":"Otolaryngol Clin North Am"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0050","DOI":"10.54844\/hamp.2024.0050","article-title":"Analysis of day surgery implementation in a large public hospital from the perspective of high-quality development","volume":"3","author":"Peng","year":"2024","journal-title":"Hosp Adm Med Pract"},{"key":"B3","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1055\/s-0039-1700949","article-title":"How safe is it to use nonsteroid anti-inflammatory drugs for post-tonsillectomy analgesia in children? 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