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Table 2 Second questionnairea administered to the Board

From: Paracetamol and ibuprofen combination for the management of acute mild-to-moderate pain in children: expert consensus using the Nominal Group Technique (NGT)

Question No

Question

Answers

1

In which cases would you use the fixed combination for the treatment of postoperative pain (having assessed the antiplatelet effect of ibuprofen in order not to compromise hemostasis)?

Select one or more options:

ENT surgery

Eye surgery

Dental surgery

Skin and soft tissue surgery

Odontalgia

Orthopedic surgery

Abdominal surgery

When paracetamol alone does not control pain

When both anti-inflammatory and analgesic effects are desired

Never

2

The fixed combination in the pediatric setting is effective in case of:

Select one or more options:

Acute rheumatic pain

Chronic rheumatic pain

Abdominal pain

3

In the pediatric field, the oral suspension of the fixed combination would be preferred because:

Select one or more options:

It maximizes the correctness of the dosage in relation to the weight of the child

It promotes regularity and completeness of the absorption of the active ingredients

It overcomes the child's frequent aversion to other pharmaceutical forms (tablets, suppositories)

It allows for quick pain control with greater effectiveness

It reduces parental dosing errors compared to the combined administration of two separate drugs

None of the above

4

The combination implies greater safety in patients suffering from concomitant diseases and/or undergoing additional treatments

Select one of the options:

Yes/No

5

What do you think is the pharmacodynamic advantage of the fixed combination?

Select one of the options:

Greater analgesic power

Greater anti-inflammatory power

Both of them

6

In case of ineffectiveness of paracetamol alone, would you use the fixed combination?

Select one or more options:

Headaches

Acute rheumatic pain

Chronic Rheumatic Pain

Earache

Post-traumatic musculoskeletal pain

Odontalgia

Abdominal pain

In cases selected exclusively based on clinical judgment (physician's preferences)

Moderate pain that does not respond to the administration of paracetamol alone in the first instance

Never

7

In case of ineffectiveness of ibuprofen alone, would you use the fixed combination?

Select one or more options:

Headaches

Acute rheumatic pain

Chronic Rheumatic Pain

Earache

Post-traumatic musculoskeletal pain

Odontalgia

Abdominal pain

In cases selected exclusively based on clinical judgment (physician's preferences)

Moderate pain that does not respond to the administration of paracetamol alone in the first instance

Never

8

Would you use the fixed combination for acute pain treatment? b

Select one or more options:

Mild (score 1–3)

Moderate (score 4–6)

Severe (score 7–10)

None

  1. aIn this questionnaire, "fixed combination" means the simultaneous administration of paracetamol and ibuprofen at a fixed dose in a 3.3:1 ratio
  2. bReference was made to the scales approved and used in Italy depending on age: FLACC (Face-Legs-Activity-Crying-Consolability) for children < 3 years, WONG-BAKER for children up to 8 years, NRS (Numeric Rating Scale) for older children