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What, Where & Why?

TRANEXAMIC ACID

The concept of multimodal analgesia is well-known. Paracetamol remains the cornerstone of rapid alleviation of pain having been around for over 100 years. The dosing regime of paracetamol is highly important in achieving consistent plasma levels of the drug. Paracetamol is a cheap drug with an extremely good safety record. There have been concerns over the years with the use of intravenous paracetamol; particularly in paediatric and neonatal populations. As we know paracetamol is a weight and dose-dependent drug and caution must be applied when prescribing in 'At Risk' populations.  However, in otherwise healthy adult cohorts paracetamol administered correctly in both dosage and interval is highly unlikely to cause any serious incident or adverse drug event and continues to be the the basis of the World Health Organisation's pain ladder. One of the most impressive things about  paracetamol is its ability to act as a synergist with multiple other medications without serious side-effects. With respect to pre-surgical prophylactic pain relief, by blocking receptors, it is one of the most commonly used drugs in the operating theatre and is widely accepted as opioid sparing. 

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