***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Intravenous acetaminophen injection ( paracetamol ) is marketed in Europe for the management of acute pain . A repeated-dose , r and omized , double-blind , placebo-controlled , three-parallel group study was performed to evaluate the analgesic efficacy and safety of intravenous acetaminophen as compared with its prodrug ( propacetamol ) and placebo . Propacetamol has been available in many European countries for more than 20 yr . Methods : After orthopedic surgery , patients reporting moderate to severe pain received either 1 g intravenous acetaminophen , 2 g propacetamol , or placebo at 6-h intervals over 24 h. Patients were allowed “ rescue ” intravenous patient-controlled analgesia morphine .  Pain intensity , pain relief , and morphine use were measured at selected intervals . Safety was monitored through adverse event reporting , clinical examination , and laboratory testing . Results : One hundred fifty-one patients ( intravenous acetaminophen : 49 ; propacetamol : 50 ; placebo : 52 ) received at least one dose of study medication . The intravenous acetaminophen and propacetamol groups differed significantly from the placebo group regarding pain relief from 15 min to 6 h ( P < 0.05 ) and median time to morphine rescue  ( intravenous acetaminophen : 3 h ; propacetamol : 2.6 h ; placebo : 0.8 h ) . Intravenous acetaminophen and propacetamol significantly reduced morphine consumption over the 24-h period : The total morphine doses received over 24 h were 38.3 ± 35.1 mg for intravenous acetaminophen , 40.8 ± 30.2 mg for propacetamol , and 57 . 4 ± 52.3 mg for placebo , corresponding to decreases of −33 % ( 19 mg ) and −29 % ( 17 mg ) for intravenous acetaminophen and propacetamol , respectively . Drug-related adverse events were reported in 8.2 % , 50 % ( most of them local ) , and 17.3 % of patients treated with intravenous acetaminophen , propacetamol , and placebo , respectively . Conclusion : Intravenous acetaminophen , 1 g , administered over a 24-h period in patients with moderate to severe pain after orthopedic surgery provided rapid and effective analgesia and was well tolerated Background A multimodal and preventative approach to providing postoperative analgesia is becoming increasingly popular for children and adults , with the aim of reducing reliance on opioids . We conducted a prospect i ve , r and omized double-blind study to compare the analgesic efficacy of intravenous paracetamol and dipyrone in the early postoperative period in school-age children undergoing lower abdominal surgery with spinal anesthesia . Methods Sixty children scheduled for elective lower abdominal surgery under spinal anesthesia were r and omized to receive either intravenous paracetamol 15 mg/kg , dipyrone 15 mg/kg or isotonic saline . The primary outcome measure was pain at rest , assessed by means of a visual analog scale 15 min , 30 min , 1 h , 2 h , 4 h and 6 h after surgery . If needed , pethidine 0.25 mg/kg was used as the rescue analgesic . Time to first administration of rescue analgesic , cumulative pethidine requirements , adverse effects and complications were also recorded . Results There were no significant differences in age , sex , weight , height or duration of surgery between the groups . Pain scores were significantly lower in the paracetamol group at 1 h ( P = 0.030 ) and dipyrone group at 2 h ( P = 0.010 ) when compared with placebo . The proportion of patients requiring rescue analgesia was significantly lower in the paracetamol and dipyrone groups than the placebo group ( vs. paracetamol P = 0.037 ; vs. dipyrone P = 0.020 ) . Time to first analgesic requirement appeared shorter in the placebo group but this difference was not statistically significant , nor were there significant differences in pethidine requirements , adverse effects or complications . Conclusion After lower abdominal surgery conducted under spinal anesthesia in children , intravenous paracetamol appears to have similar analgesic properties to intravenous dipyrone , suggesting that it can be used as an alternative in the early postoperative period . Trial registration Clinical Trials.gov . Identifier : NCT01858402 BACKGROUND This study assessed the analgesic efficacy , side effects , and time to extubation of intravenous paracetamol when administered as an adjuvant to intravenous meperidine  after major surgery in intensive care unit ( ICU ) . MATERIAL Patients were r and omized postoperatively into 2 groups in ICU . Patients received either 100 mL of serum saline intravenous ( IV ) every 6 hours and IV meperidine ( n = 20 group M ) or IV paracetamol 1 g every 6 hours and IV meperidine ( n = 20 , group MP ) into a peripheral vein for 24 hours . Behavioral Pain Scale ( BPS ) is used until extubation , and visual analog score ( VAS ) is used after extubation . When BPS and VAS values were more than 4 , meperidine , 1 mg/kg IV , was administered and noted in 2 groups . Pain scores , total meperidine consumption , time to extubation , sedation scores , and side effects are 24-hour postoperatively noted . RESULTS Behavioral Pain Scale and VAS scores are significantly lower in group paracetamol-meperidine at 24 hours ( P < .05 ) . In group MP , postoperative meperidine consumption ( 76.75 ± 18.2 mg vs. 198 ± 66.4 mg ) and extubation time ( 64.3 ± 40.6 min vs. 204.5 ± 112.7 min ) were lower than in group M ( P < .01 ) . In addition to , postoperative nausea-vomiting and sedation scores were significantly lower in group MP when compared with group M ( P < .05 ) . CONCLUSION We have demonstrated important clinical benefits by the addition of 4 g/d of paracetamol to meperidine after major surgery . This benefit has been shown in a range of patients under routine clinical conditions and therefore has important practical consequences in ICU . These data suggest that intravenous paracetamol is a useful component of the multimodal analgesia model , especially after major surgery OBJECTIVES The purpose of the present study was to determine the efficacy of intravenous ( iv ) paracetamol and iv lornoxicam on postoperative analgesia and the reduction in tramadol consumption . METHODS Sixty patients ( ASA class 1 - 2 , age : 18 - 72 years ) undergoing thyroidectomy were enrolled in the study , and were r and omized into three groups : Group L received 8 mg of iv lornoxicam , Group P received 1 g iv paracetamol and Group C received 100 cc of iv saline solution . All patients received st and ard general anesthesia . The postoperative salvage analgesic consumption was recorded at 0 - 6 , 6 - 12 and 12 - 24 hour ( h ) intervals . Pain scores were evaluated with a visual analogue scale at 15 min , and 1 , 2 , 4 , 6 , 8 , 12 , 18 , and 24 h postoperatively . RESULTS The time to first analgesic requirement was approximately 127.5 min in Group L , 162.3 in Group P and 35.5 min in Group C , and the time was found to be significantly prolonged in Group L and Group P. Pain scores were significantly lower in Group P and Group L at 15 min , and 1 , 8 , 12 , and 18 h. Twenty-four hour analgesic consumption was significantly lower in Group P and Group L compared to Group C. Supplemental analgesics requirement was as follows : 100 % in Group C , 50 % in Group L and 55 % in Group P. The degree of satisfaction with postoperative pain management was excellent in 90 % in Groups L and P , versus in only 30 % in Group C. CONCLUSION Administration of iv lornoxicam and iv paracetamol following thyroid surgery decreased the postoperative pain scores and opioid requirement , as well as the incidence of nausea and vomiting , while also prolonging the time to the first analgesic supplement BACKGROUND The purpose of this r and omized double-blind study was to compare the efficacy and safety of propacetamol 2 g ( an i.v . acetaminophen 1 g formulation ) administered as a 2-min bolus injection ( n=50 ) or a 15-min infusion ( n=50 ) with oral acetaminophen 1 g ( n=50 ) or placebo ( n=25 ) for analgesia after third molar surgery in patients with moderate to severe pain after impacted third molar removal . METHODS All patients were evaluated for efficacy during the initial 6 h period after treatment administration ( T(0 ) ) and for safety during the entire week after T(0 ) . RESULTS The onset of analgesia after propacetamol was shorter ( 3 min for bolus administration , 5 min for 15-min infusion ) than after oral acetaminophen ( 11 min ) . Active treatments were significantly better for all parameters ( pain relief , pain intensity , patient 's global evaluation , duration of analgesia ) than placebo ( P<0.05 ) . Adverse events were more frequent after propacetamol , especially pain at the injection site . Propacetamol bolus result ed in a much higher incidence of local adverse events than the infusion ( propacetamol bolus 90 % vs propacetamol infusion 52 % ) with no clinical ly significant benefits in terms of analgesic efficacy . CONCLUSION I.V. propacetamol , administered as a 15-min infusion , is a fast-acting analgesic agent . It is more effective in terms of onset of analgesia than a similar dose of oral acetaminophen Background In recent years , intravenously ( IV ) administered acetaminophen has become one of the most common perioperative analgesics . Despite its now-routine use , IV acetaminophen ’s analgesic comparative efficacy has never been compared with that of ketamine , a decades-old analgesic familiar to obstetricians , gynecologists , and anesthesiologists alike . This doubleblind clinical trial aim ed to evaluate the analgesic effects of ketamine and IV acetaminophen on postoperative pain after abdominal hysterectomy . Methods Eighty women aged 25–70 years old and meeting inclusion and exclusion criteria were r and omly allocated into two groups of 40 to receive either IV acetaminophen or ketamine intraoperatively . Postoperatively , each patient had patient-controlled analgesia . Pain and sedation ( Ramsay Sedation Scale ) were documented based on the visual analog scale in the recovery room and at 4 hours , 6 hours , 12 hours , and 24 hours after the surgery . Hemodynamic changes , adverse medication effects , and the need for breakthrough meperidine were also recorded for both groups . Data were analyzed by repeated- measures analysis of variance . Results Visual analog scale scores were significantly lower in the IV acetaminophen group at each time point ( P<0.05 ) , and this group required significantly fewer doses of breakthrough analgesics compared with the ketamine group ( P=0.039 ) . The two groups had no significant differences in terms of adverse effects . Conclusion Compared with ketamine , IV acetaminophen significantly improved postoperative pain after abdominal hysterectomy BACKGROUND Intravenous administration is the route of choice for drug therapy in the immediate postoperative period . Propacetamol ( ProAPAP ) , an injectable prodrug of paracetamol requiring reconstitution , has demonstrated efficacy in managing acute pain and fever . However , it has been associated with pain at the injection site . A stable , ready-to-use formulation of paracetamol solution infused intravenously ( IV-APAP ) has been developed and might be associated with less pain at the injection site compared with ProAPAR . OBJECTIVE The objective of this study was to assess the tolerability and efficacy of a single dose of IV APAP 1 g compared with those of a single dose of ProAPAP 2 g in patients with moderate to severe pain after minor gynecologic surgery . METHODS This single-dose , r and omized , double-blind , active-controlled,2-parallel-group study was conducted at 23 hospitals and outpatient clinics in France . After minor gynecologic surgery , patients reporting moderate to severe pain were r and omized to receive a single 15-minute infusion of IV-APAP 1 g or ProAPAP 2 g ( bioeyuivalent doses ) . Tolerability was monitored using local and systemic adverse event ( AE ) reporting , clinical examination including vital sign measurement , and patients ' ratings of acceptability of the infusion . Efficacy end points included pain intensity at 0 , 1 , 2 , 4 , and 6 hours ; median time to rescue medication ( defined as the time at which 50 % of patients requested rescue medication ) ; and percentage of patients requesting rescue medication . Patients ' satisfaction with the study drugs was assessed using patient 's global evaluation ( PGE ) and the percentage of patients willing to receive the 
    Output:
    
However , this did not translate to a clinical ly meaningful reduction in opioid-induced adverse events .
Adverse events occurred at similar rates with IV paracetamol or IV propacetamol and placebo .
Meta- analysis did not demonstrate clinical ly meaningful differences between IV paracetamol/propacetamol and active comparators for any adverse event .
Low to very low quality evidence demonstrates that both formulations are associated with few adverse events , although patients receiving IV propacetamol have a higher incidence of pain on infusion than both placebo and IV paracetamol