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Post-Stroke Temperature Cut By High-Dose Acetaminophen
Stroke
07/06/2001
By Anne MacLennan
A daily dose of 6000 mg acetaminophen may result in a small but possibly beneficial decrease in body temperature shortly after ischemic stroke, even in patients with no fever.
Whether this effect is reproducible, however, needs to be the focus of further study.
So, too, does the question of whether early reduction of body temperature leads to improved outcome, suggest these authors. For now, it is clear body temperature is a strong predictor of outcome in acute stroke.
It is unknown, though, whether antipyretic treatment leads to early and clinically worthwhile reduction of body temperature in patients with acute stroke, especially those who are normothermic and subfebrile.
To examine whether early treatment of acute ischemic stroke patients with acetaminophen (paracetamol) reduces body temperature was the main objective of this double-blind trial by researchers in the Netherlands on behalf of the PAPAS Investigators.
Dr D.W.J. Dippel and colleagues from University Hospital Rotterdam, Rotterdam, Eemland Ziekenhuis, Amersfoort, and University Medical Center Utrecht, Utrecht did this work.
Participants were 75 patients with acute ischemic stroke confined to the anterior circulation.
Patients were randomly assigned to treatment with 500 mg (low dose) or 1,000 mg (high dose) acetaminophen or with placebo, all administered as suppositories six times daily over five days.
Researchers measured body temperatures with a rectal electronic thermometer at the start of treatment and after 24 hours and with an infrared tympanic thermometer at two-hour intervals during the first 24 hours and at six-hour intervals after that. Primary outcome measure was rectal temperature at 24 hours after start of treatment.
The study found treatment with the high-dose acetaminophen resulted in 0.4 degrees C lower body temperatures than did placebo treatment at 24 hours. From baseline, mean reduction with high-dose acetaminophen was 0.3 degrees C higher than that in patients on placebo.
Treatment with low-dose acetaminophen did not result in lower body temperatures.
No differences in temperature were found after days five days of treatment between the placebo and the high- or low-dose acetaminophen groups.
Stroke. 2001;32:1607.
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