Intravenous Acetaminophen Does Not Reduce Peri-operative Acute Pain Or Narcotic Use in Bariatric Surgery Patients

Amy L Rosenbluth, BS, Morgan A Bresnick, MD, Renee Tholey, MD, Kathleen Lamb, MD, Michael R Kammerer, MD, Alec C Beekley, MD, David S Tichansky, MD. Thomas Jefferson University.

Introduction– Narcotic pain medications continue to be the mainstay of postoperative pain management. It has been previously shown that use of intravenous acetaminophen in the peri-operative period can reduce acute pain, thus reducing narcotic use and potential narcotic-related side effects and complications. The specific objective of this study was to determine if peri-operative use of intravenous acetaminophen would reduce peri-operative pain and narcotic use in the bariatric surgery population.

Methods– In October 2011, routine administration of 1000mg of intravenous acetaminophen at the end of bariatric procedures was established. After obtaining IRB approval, the records of consecutive bariatric surgery patients were retrospectively examined. Patients were separated into two groups of fifty patients each: Group A – patients who received intravenous acetaminophen; and Group B – patients who did not receive intravenous acetaminophen. Pain scores and narcotic usage (morphine equivalents) in the PACU were recorded. Average pain scores and narcotic usage for the two groups were compared using XLSTAT software.

Results– The average PACU pain scores, on a 10-point scale, for group A and group B were 4.94 and 4.34, respectively. The average morphine equivalent use in the PACU for group A and group B were 8.67 mg and 8.81 mg, respectively. There was no statistical difference in either average pain scores (p=0.15) or morphine use (p=0.51) between the two groups.

Conclusion– These data show that use of intravenous acetaminophen in the peri-operative period does not reduce acute pain or narcotic use in the bariatric patient population. Given these findings, IV acetaminophen is not a cost effective measure for pain control in the immediate postoperative period.
 

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