• Muhammad Saad Yousuf, Ayesha Saleem, Abdul Monem, Zafar Nazir, and Fauzia Anis Khan.
• Department of Anaesthesiology, The Aga Khan University and Hospital, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2025 Jan 1; 35 (1): 111611-16.

ObjectiveTo explore the impact of perioperative intravenous (IV) paracetamol, administered with caudal ropivacaine on the quality of postoperative recovery in children undergoing hypospadias repair.Study DesignDouble-blinded randomised controlled trial. Place and Duration of the Study: The operating room, post-anaesthesia care unit (PACU), and paediatric surgical ward at the Aga Khan University Hospital, from 31st January 2019 to 1st May 2022.MethodologyChildren aged 3-10 years undergoing hypospadias repair were randomly divided into two groups. Group P was administered IV paracetamol 15 mg/kg an hour before the completion of the repair procedure. Group C received a placebo instead of paracetamol. Modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) was measured at 15 and 30 minutes, and at 1, 2, 4, and 6 hours postoperatively. The sedation score was documented for four hours postoperatively.ResultsOut of total 59 children included in the analysis, 55% (n = 16) in the Group P and 45% (n = 13) in the Group C needed additional analgesia within the first six hours post-procedure. No significant variations were observed between the groups' CHEOPS scores and sedation levels.ConclusionThe addition of perioperative intravenous paracetamol 15 mg/kg in combination with 0.25% ropivacaine through the caudal route, along with general anaesthesia, did not significantly affect the quality of postoperative recovery in children measured by pain score and sedation.Key WordsIntravenous paracetamol, Caudal analgesia, Ropivacaine, Paediatric patients.

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