Intravenous Acetaminophen

Abstract

MOST PATIENTS WHO UNDERGO surgical procedures will experience acute postoperative pain. The use of multimodal analgesia, defined as the concurrent use of various analgesic drugs or techniques that target different mechanisms of analgesia, is recommended for the management of postoperative pain. 1 Chou R. Gordon D.B. de Leon-Casasola O.A. et al. Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016; 17: 131-157 Abstract Full Text Full Text PDF PubMed Scopus (1551) Google Scholar The goal of multimodal analgesia is to maximize the use of one or more scheduled (around the clock) nonopioid analgesics, as well as nonpharmacologic therapies, to minimize or eliminate the need for opioids and their often unacceptable adverse effects. The current recommendation (strong recommendation and high-quality evidence) is to provide acetaminophen and/or nonsteroidal anti-inflammatory drugs (NSAIDs) as part of multimodal analgesia for management of postoperative pain in adults and children unless contraindicated. 1 Chou R. Gordon D.B. de Leon-Casasola O.A. et al. Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016; 17: 131-157 Abstract Full Text Full Text PDF PubMed Scopus (1551) Google Scholar An analgesic regimen that includes acetaminophen or an NSAID generally provides improved analgesia or less opioid consumption compared with an opioid alone. 2 Gimbel J.S. Brugger A. Zhao W. et al. Efficacy and tolerability of celecoxib versus hydrocodone/acetaminophen in the treatment of pain after ambulatory orthopedic surgery in adults. Clin Ther. 2001; 23: 228-241 Abstract Full Text PDF PubMed Scopus (132) Google Scholar , 3 Kinsella J. Moffat A.C. Patrick J.A. et al. Ketorolac trometamol for postoperative analgesia after orthopedic surgery. Br J Anaesth. 1992; 69: 19-22 Crossref PubMed Scopus (63) Google Scholar , 4 Grundmann U. Wornie C. Beidler A. et al. The efficacy of the non-opioid analgesics parecoxib, paracetamol and metamizol for postoperative pain relief after lumbar microdiscectomy. Anesth Analg. 2006; 103: 217-222 Crossref PubMed Scopus (102) Google Scholar Julie Golembiewski, PharmD, is a Clinical Associate Professor, Departments of Pharmacy Practice and Anesthesiology, University of Illinois at Chicago, Chicago, IL