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Effect of Preemptive Acetaminophen on Opioid Consumption: A Meta-Analysis
Chengluan Xuan1, Wen Yan2, Dan Wang1
1Department of Anesthesia, The First Hospital of Jilin University, Jilin, China.
Pain Physician
|March 19, 2021
Summary
Preemptive acetaminophen significantly reduces postoperative opioid use and pain scores within 24 hours after general anesthesia. This meta-analysis also found reduced nausea and vomiting, though more high-quality trials are needed.
Area of Science:
- Anesthesiology
- Pharmacology
- Pain Management
Background:
- Strategies to decrease postoperative opioid consumption are critical due to the ongoing opioid epidemic.
- Preemptive analgesia is a proposed method, but its efficacy remains debated.
- Evaluating acetaminophen's role in preemptive analgesia is essential.
Purpose of the Study:
- To assess the effectiveness of a single dose of acetaminophen as preemptive analgesia.
- To analyze its impact on opioid consumption and pain in patients under general anesthesia.
Main Methods:
- A meta-analysis of randomized controlled trials (RCTs) was conducted.
- Searches were performed across major databases: PubMed, EMBASE, Cochrane Library, and Web of Science.
- Studies comparing preemptive acetaminophen to placebo in general anesthesia patients were included and assessed for bias.
Main Results:
- Six studies involving 563 patients were analyzed.
- Preemptive acetaminophen significantly reduced 24-hour opioid consumption (SMD -1.45, P = 0.002).
- It also lowered postoperative pain scores at 12 hours (SMD -0.86, P < 0.0001) and decreased nausea (RR 0.45, P < 0.001) and vomiting (RR 0.39, P = 0.002).
Conclusions:
- Single-dose preemptive acetaminophen effectively lowers opioid requirements, pain, nausea, and vomiting post-general anesthesia.
- The findings suggest a beneficial role for acetaminophen in multimodal analgesia.
- Further high-quality RCTs are recommended to confirm these results and address limitations.
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