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Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial
Ravi Bhoja1, Matthew W Ryan2, Kevin Klein1
1Department of Anesthesiology and Pain Management The University of Texas Southwestern Dallas Texas USA.
Laryngoscope Investigative Otolaryngology
|June 30, 2020
Summary
For sinus surgery patients, intravenous acetaminophen showed no pain relief advantage over oral acetaminophen. Both methods provided similar postoperative pain management and opioid use.
Area of Science:
- Anesthesiology
- Pain Management
- Otolaryngology
Background:
- Multimodal perioperative analgesia, including acetaminophen, is guideline-recommended.
- Comparative efficacy of IV vs. oral acetaminophen in sinus surgery is not well-established.
- Current guidelines recommend multimodal perioperative analgesia, including acetaminophen.
Purpose of the Study:
- To compare the efficacy of intravenous (IV) versus oral acetaminophen for postoperative pain relief after sinus surgery.
- To determine if IV acetaminophen offers superior analgesia compared to oral acetaminophen in the context of sinus surgery.
Main Methods:
- Prospective randomized trial with blinded endpoint assessment.
- Functional endoscopic sinus surgery patients randomized to IV or oral acetaminophen.
- Primary outcome: visual analogue scale (VAS) pain score at 1 hour postoperatively.
Main Results:
- No significant difference in VAS pain scores at 1 hour postoperatively between IV and oral acetaminophen groups.
- No significant difference in pain scores at 24 hours postoperatively.
- Postoperative opioid usage was similar between the two groups in the postanesthesia care unit and over 24 hours.
Conclusions:
- IV acetaminophen provides no significant advantage over oral acetaminophen for pain management after sinus surgery.
- This study is the first to directly compare oral and IV acetaminophen efficacy in sinus surgery patients.
- Findings suggest oral acetaminophen is a viable and equivalent option for postoperative analgesia in this patient population.
