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Intravenous Acetaminophen for Perioperative Pain Control in Adult Elective Neurospine Surgical Patients: A
Fengyan Deng1, Susan D Horn2, Randall J Smout3
1received her master's degree in nurse anesthesia from the University of Pittsburg School of Nursing, Pittsburgh, Pennsylvania, in 2009. She received her doctoral degree in nursing practice (DNP) from the University of Texas Health Science Center at Houston School of Nursing, Houston, Texas, in 2014. She has been working as a Certified Registered Nurse Anesthetist for more than 5 years at Houston Methodist Hospital in the Texas Medical Center, Houston, Texas. Her current employer is United States Anesthesia Partners.
Abstract:
Adding intravenous (IV) acetaminophen to an opioid-based regimen as multimodal pain management for perioperative pain control in adults undergoing spine surgery can lead to effective pain control, reduce the risk of opioid-related adverse effects, and facilitate postoperative neurologic evaluation for surgical outcomes. This descriptive pilot study investigated the analgesic effect of a single dose of IV acetaminophen administered intraoperatively as routine practice for perioperative pain management for adults undergoing elective spine surgery. A retrospective comparative cohort study compared an IV acetaminophen group with a group not receiving IV acetaminophen for primary outcomes measured by visual analog scale (VAS) and associated secondary outcomes. The IV acet-aminophen group had lower mean VAS scores than the group not receiving IV acetaminophen (4.33 vs 6.22, P = .01, at 60 minutes after entry into the postanesthesia care unit [PACU] for procedure level 4; 2.43 vs 3.11, P = .002, at PACU discharge for procedure level 3). The study did not show consistently lower VAS scores for the IV acetaminophen group vs the group not receiving IV acetaminophen. No difference was found for other secondary outcomes between groups. Future prospective studies are needed to assess the analgesic effects of IV acetaminophen for spine surgery cases.
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