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324258

The hypotension caused by intravenous paracetamol in septic shock patients: A single center placebo controlled randomized study

Article

Last updated: 27 Dec 2024

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Abstract

According to the product information for parenteral paracetamol, fewer than 1% of patients will have more severe adverse effects like hypotension. However, a number of studies suggest that the prevalence of paracetamol induced hypotension may be higher than the drug's producers. We carried out prospective, controlled, randomized research to compare the clinical implications of intravenous paracetamol bolus versus intravenous paracetamol extended infusion. The 61 adult septic shock were divided into three groups by randomization: Bolus group who received paracetamol 1g/100ml infused over 15 minutes, while the extended infusion group who received paracetamol 1g/100ml infused over 3 hours. The control group who received normal saline 100ml infused over 15 minutes. The main outcome was the incidence and prevalence of reduced blood pressure, which was detected by a systolic blood pressure drop of ≥ 20٪ from baseline. Mean arterial pressure, vasopressor infusion flow rate, and both diastolic and systolic blood pressure did not change significantly according to statistical analysis between the three groups at baseline, one, three, or six hours after the intervention. The incidence of hypotension was 19% (4 of 21 ) within the control or normal saline group, 50% (10 of 20 ) within the bolus group, and 35% (7 of 20) within the extended infusion group. The prevalence of hypotensive episodes was greater in the bolus group, but there was no clinically meaningful difference between intravenous paracetamol prolonged infusion and bolus. We do not need to administer paracetamol as a prolonged infusion to prevent the negatively impacted of paracetamol.

DOI

10.21608/aijpms.2023.221239.1223

Keywords

intravenous, Paracetamol, acetaminophen, Septic shock, blood pressure, hypotension, vasopressors

Authors

First Name

Ayah

Last Name

Khalil

MiddleName

M

Affiliation

Department of Clinical Pharmacy ,Cairo University Hospitals(Kasr alainy), Cairo, Egypt

Email

drayaaa1991@gmail.com

City

-

Orcid

-

First Name

Ahmed

Last Name

Mukhtar

MiddleName

M

Affiliation

Department of Anesthesia, Intensive Care and Pain Management, Cairo University, Faculty of Medicine, Cairo, Egypt

Email

ahmed.mukhtar@kasralainy.edu.eg

City

Cairo

Orcid

-

First Name

Ahmed

Last Name

Lotfy

MiddleName

M

Affiliation

Department of Anesthesia, Intensive Care and Pain Management, Cairo University, Faculty of Medicine, Cairo, Egypt

Email

ahmed.lotfy@kasralainy.edu.eg

City

Cairo

Orcid

-

First Name

Karima

Last Name

Abu EL-Fotuh

MiddleName

-

Affiliation

Department of Clinical Pharmacy, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt

Email

karimasoliman.pharmg@azhar.edu.eg

City

Cairo

Orcid

-

First Name

Zeinab

Last Name

Zalat

MiddleName

A

Affiliation

Department of Clinical Pharmacy, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt

Email

zeinabalkasaby.pharmg@azhar.edu.eg

City

Tanta

Orcid

-

Volume

4

Article Issue

1

Related Issue

44808

Issue Date

2024-01-01

Receive Date

2023-07-05

Publish Date

2024-01-01

Page Start

189

Page End

195

Print ISSN

2735-4598

Online ISSN

2735-4601

Link

https://aijpms.journals.ekb.eg/article_324258.html

Detail API

https://aijpms.journals.ekb.eg/service?article_code=324258

Order

14

Type

Original research articles

Type Code

1,562

Publication Type

Journal

Publication Title

Azhar International Journal of Pharmaceutical and Medical Sciences

Publication Link

https://aijpms.journals.ekb.eg/

MainTitle

The hypotension caused by intravenous paracetamol in septic shock patients: A single center placebo controlled randomized study

Details

Type

Article

Created At

27 Dec 2024