Intravenous Acetaminophen Does Not Decrease Persistent Surgical Pain After Cardiac Surgery.

Area of Science:

• Anesthesiology
• Pain Management
• Cardiothoracic Surgery

Background:

• Post-sternotomy pain is a common complication after cardiac surgery.
• Effective pain management strategies are crucial for patient recovery and quality of life.

Purpose of the Study:

• To investigate the efficacy of perioperative intravenous acetaminophen in reducing incisional pain at 30 and 90 days post-cardiac surgery.
• To test the hypothesis that acetaminophen administration decreases long-term incisional pain after median sternotomy.

Main Methods:

• Prospective, randomized, double-blind, placebo-controlled trial conducted in a single tertiary-care cardiac surgery unit.
• Patients undergoing median sternotomy received either intravenous (IV) acetaminophen (1g every 6 hours for 24 hours) or IV placebo.
• Incisional pain severity was assessed via phone at 30 and 90 days post-surgery using validated questionnaires.

Main Results:

• Intravenous acetaminophen showed no significant effect on incisional pain severity at 30 days (p=0.88) or 90 days (p=0.83).
• Estimated difference in means for pain severity was 0.06 (95% CI -0.87 to 0.99) at 30 days and 0.07 (95% CI -0.71 to 0.86) at 90 days.
• Low pain severity and neuropathic pain interference were observed regardless of treatment group at both time points.

Conclusions:

• Perioperative IV acetaminophen is not effective in reducing the incidence or intensity of incisional pain at 30 and 90 days following cardiac surgery.
• Current evidence does not support the routine use of IV acetaminophen for long-term incisional pain management after median sternotomy.