PS02.227: A NEW POSTOPERATIVE PAIN MANAGEMENT LEADS TO ENHANCED RECOVERY AFTER ESOPHAGECTOMY: A PROPENSITY SCORE-MATCHED ANALYSIS

Abstract

Abstract Background Opioid use is reportedly associated with delayed recovery after surgery because of gastrointestinal motility disorder and postoperative nausea and vomiting despite of acceptable efficacy for pain control.The aim of this study was to investigated the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhanced recovery after esophagectomy. Methods Of 93 and 57 consecutive patients who underwent esophagectomy for esophageal cancer before and after introduction of postoperative scheduled intravenous acetaminophen, propensity score-matched population was created and short-term clinical outcomes were compared. Results Significant defervescence was demonstrated in Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (P < 0.05), whereas no significant difference was observed in postoperative inflammatory parameters. The incidence of postoperative complications was similar between the groups. The number of PCA pushes and the frequency of use of other non-opioid analgesics was significantly reduced in the A-group (P < 0.05). Both daily and cumulative opioid use was significantly reduced in the A-group (P < 0.05). The time to first flatus and defecation significantly decreased in the A-group (P = 0.001 and P = 0.035, respectively). The day of first walking after surgery significantly decreased in the A-group (1.0 vs. 2.0 days, P < 0.001). The ICU stay (3.05 vs. 3.62 days, P = 0.003) and the hospital stay (21.6 vs.26.8 days, P = 0.074) tended to be decreased in the A-group. Conclusion Scheduled postoperative intravenous acetaminophen after esophagectomy may reduce the use of opioids and might be associated with enhanced GI motility and decreased incidence of PONV. Scheduled intravenous acetaminophen may be a feasible new pain management option in ERAS protocol after esophagectomy. Disclosure All authors have declared no conflicts of interest.