Preoperative cesarean delivery intravenous acetaminophen treatment for postoperative pain control: a randomized double-blinded placebo control trial

Background Acetaminophen is a non-opioid analgesic commonly utilized for pain control after several types of surgical procedures. Methods This scoping primary literature review provides recommendations for intravenous (IV) acetaminophen use based on type of surgery. Results Intravenous acetaminophen has been widely studied for postoperative pain control and has been compared to other agents such as NSAIDs, opioids, oral/rectal acetaminophen, and placebo. Some of the procedures studied include abdominal, gynecologic, orthopedic, neurosurgical, cardiac, renal, and genitourinary surgeries. Results of these studies have been conflicting and largely have not shown consistent clinical benefit. Conclusion Overall, findings from this review did not support the notion that IV acetaminophen has significant efficacy for postoperative analgesia. Given the limited clinical benefit of IV acetaminophen, especially when compared to the oral or rectal formulations, use is generally not justifiable.

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Efficacy of Intravenous Acetaminophen in Length of Stay and Postoperative Pain Control in Laparoscopic Roux-en-Y Gastric Bypass Surgery Patients

Bariatric Surgical Practice and Patient Care ◽

10.1089/bari.2018.0005 ◽

2018 ◽

Vol 13 (3) ◽

pp. 103-108 ◽

Cited By ~ 1

Author(s):

Matthew Lange ◽

Christina W. Lee ◽

Tara Knisely ◽

Subbaiah Perla ◽

Kimberly Barber ◽

...

Keyword(s):

Gastric Bypass ◽

Postoperative Pain ◽

Length Of Stay ◽

Pain Control ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Postoperative Pain Control ◽

Intravenous Acetaminophen

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Small Doses of Intrathecal Morphine Combined with Systemic Diclofenac for Postoperative Pain Control After Cesarean Delivery

Anesthesia & Analgesia ◽

10.1097/00000539-199803000-00017 ◽

1998 ◽

Vol 86 (3) ◽

pp. 538-541 ◽

Cited By ~ 9

Author(s):

Monica M. S. C. Cardoso ◽

Jose C. A. Carvalho ◽

Antonio R. Amaro ◽

Ademar A. Prado ◽

Elizabeth L. Cappelli

Keyword(s):

Postoperative Pain ◽

Cesarean Delivery ◽

Pain Control ◽

Intrathecal Morphine ◽

Postoperative Pain Control ◽

Small Doses

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The effect of ketorolac on posterior thoracolumbar spinal fusions: a prospective double-blinded randomised placebo-controlled trial protocol

BMJ Open ◽

10.1136/bmjopen-2018-025855 ◽

2019 ◽

Vol 9 (1) ◽

pp. e025855 ◽

Cited By ~ 1

Author(s):

Chad F Claus ◽

Evan Lytle ◽

Doris Tong ◽

Diana Sigler ◽

Dominick Lago ◽

...

Keyword(s):

Postoperative Pain ◽

Length Of Stay ◽

Pain Control ◽

Average Length ◽

Controlled Trial ◽

Opioid Use ◽

Postoperative Pain Control ◽

Minimal Effective Dose ◽

Spinal Fusions ◽

Double Blinded

IntroductionKetorolac has been shown to provide quality postoperative pain control and decrease opioid requirement with minimal side effects following spinal surgery. However, the literature addressing its use in spinal fusions is highly variable in both its effectiveness and complications, such as pseudarthrosis. Recent literature postulates that ketorolac may not affect fusion rates and large randomised controlled trials are needed to demonstrate ketorolac as a safe and effective adjuvant treatment to opioids for postoperative pain control.Methods and analysisThis is a multihospital, prospective, double-blinded, randomised placebo-controlled trial. Data concerning fusion rates, postoperative opioid use, pain scores, length of stay will be recorded with the aim of demonstrating that the use of ketorolac does not decrease thoracolumbar spinal fusion rates while identifying possible adverse events related to short-term minimal effective dose compared with placebo. Additionally, this investigation aims to demonstrate a decrease in postoperative opioid use demonstrated by a decrease in morphine equivalence while showing equivalent postoperative pain control and decrease the average length of stay.Ethics and disseminationEthical approval was obtained at all participating hospitals by the institutional review board. The results of this study will be submitted for publication in peer-reviewed journals.Trial registration numberNCT03278691.

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