Can intravenous acetaminophen reduce the needs to more opioids to control pain in intubated patients?

Abstract

Aims:To evaluate the effect of intravenous (IV) acetaminophen on reducing the need for morphine sulfate in intubated patients admitted to the Intensive Care Unit (ICU).Settings and Design:Current study was done as a clinical trial on the patients supported by mechanical ventilator.Subjects and Methods:Behavioral pain scale (BPS) scoring system was used to measure pain in the patients. All of the patients received 1 g, IV acetaminophen, every 6 h during the 1st and 3rd days of admission and placebo during the 2nd and 4th days. Total dose of morphine sulfate needed, its complications, and the BPS scores at the end of every 6 h interval were compared.Results:Totally forty patients were enrolled. The mean pain scores were significantly lower in the 2nd and 4th days (4.33 and 3.66, respectively; mean: 4.0) in which the patients had received just morphine sulfate compared to the 1st and 3rd days (7.36 and 3.93, respectively; mean: 5.65) in which the patients had received acetaminophen in addition to morphine sulfate too (P < 0.001). Cumulative dose of morphine sulfate used, was significantly higher in the 1st and 3rd days (8.92 and 3.15 mg, respectively; 12.07 mg in total) compared to the 2nd and 4th days (6.47 mg and 3.22 mg, respectively; 9.7 mg in total) (P = 0.035).Conclusion:In our study, IV acetaminophen had no effect on decreasing the BPSs and need of morphine sulfate in intubated patients admitted to ICU.