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Effect of Intravenous Acetaminophen on Postoperative Hypoxemia After Abdominal Surgery: The FACTOR Randomized Clinical Trial

  • 0Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio.
Jama +

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July 29, 2020

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July 29, 2020

View abstract on PubMed

Summary

This summary is machine-generated.

Postoperative hypoxemia was not significantly reduced by intravenous acetaminophen compared to placebo in abdominal surgery patients. This study does not support its use for decreasing hypoxemia duration.

Area Of Science

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Outcomes

Background

  • Opioid-induced ventilatory depression and hypoxemia are common postoperative complications.
  • Nonopioid analgesics may reduce opioid consumption and subsequent hypoxemia.

Purpose Of The Study

  • To test if intravenous acetaminophen reduces the duration of hypoxemia compared to placebo in postoperative patients.
  • To evaluate the impact of acetaminophen on opioid consumption and pain.

Main Methods

  • A randomized, placebo-controlled, double-blind trial involving 570 patients undergoing abdominal surgery.
  • Patients received intravenous acetaminophen (1g) or placebo every 6 hours for 48 hours postoperatively.
  • Primary outcome was the total duration of hypoxemia (SpO2 <90%) over 48 hours.

Main Results

  • The median duration of hypoxemia was not significantly different between the acetaminophen and placebo groups (0.7 vs 1.1 minutes/hour, P=.29).
  • No significant differences were observed in secondary outcomes, including opioid consumption, pain scores, nausea, vomiting, and sedation.
  • Mean pain scores were similar (4.2 vs 4.4) and opioid use was not significantly reduced.

Conclusions

  • Postoperative intravenous acetaminophen did not significantly reduce the duration of hypoxemia in patients undergoing abdominal surgery.
  • The findings do not support the use of intravenous acetaminophen for the specific purpose of reducing postoperative hypoxemia.
  • Further research may be needed to explore alternative strategies for managing postoperative hypoxemia.