Comparison of intravenous acetaminophen with adjunct opioids versus standard pain management in postoperative patients

Objectives: To compare efficacy and safety in postoperative patients receiving intravenous acetaminophen with adjunct opioids versus standard pain management therapy.

Methods: Retrospective multicenter analysis at Saint Joseph Hospital and Saint Joseph East in Lexington, Kentucky. Patients 18 years and older who received postoperative pain management for specific surgical procedures were included. Patients with multiple surgical procedures per encounter were excluded. The treatment group received intravenous acetaminophen with adjunct opioids and was matched with a control group that received standard postoperative pain management. For every patient in the treatment group, 2 similar patients in the control group were matched by age, gender, surgeon, and surgical procedure. Primary outcome measures were pain control from pain score and length of hospitalization. Secondary measures were total amount of opioid use, and nausea and vomiting events.

Results: 47 patients met inclusion criteria in the treatment group and of the 4810 patients evaluated, 94 met criteria to be matched in the control group. Based on documentation, the treatment group demonstrated an average pain score of 3.550 compared to 3.516 and length of hospitalization was 1.620 versus 1.617 in the control group. Incidence of nausea and vomiting was observed an average of 0.83 in the treatment group versus 0.65 in the control. Additional data between the two groups are currently being analyzed to demonstrate statistical significance. 

Conclusion: Adequate pain management is critical in postoperative care and better options are necessary to decrease recovery time and utilization of resources. Studies suggest synergistic utility of intravenous acetaminophen with opiates to improve pain management using visual analog scales (VAS) assessment with minimal side effects. Conclusions for this study are pending further analysis.