This retrospective cohort included 336 elective cranial-surgery patients. Propensity matching at 1:2 retained 193 patients: 78 receiving pre-emptive oral paracetamol and 115 controls. Regression examined fentanyl use and haemodynamic responses.
Key findings
- Paracetamol was associated with 5.1 micrograms/hour less fentanyl (95% CI approximately −9.3 to −0.8; p=0.02), with no significant intubation-haemodynamic difference. The magnitude was not considered clinically meaningful.
Why this matters globally
Opioid-sparing strategies matter in neurosurgery, where sedation can complicate neurological assessment. This result illustrates that statistical significance is not the same as patient-important benefit.
Thai researcher contribution
The Prince of Songkla University team analysed real-world cranial-surgery care and explicitly distinguished statistical from clinical significance.
Limitations to consider
The study was retrospective and non-randomised. Fentanyl per hour is a surrogate rather than pain, adverse effects or recovery. Full post-match balance is not reported in the abstract.