Purpose: Although intravenous acetaminophen is commonly used for the management of postoperative pain, very limited evidence supports the usefulness of preoperative administration. The aim of this study was to determine the analgesic effect of preoperative acetaminophen on opioid consumption, pain scores, and side effects in patients receiving an elective abdominal hysterectomy.
Methods: A randomized, double-blinded, placebo-controlled clinical trial was performed in 76 women undergoing abdominal hysterectomy. Patients received either acetaminophen 2 g (group A) or placebo (group C) intravenously 30 min before surgery under general anesthesia. Postoperative pain was treated with patient-controlled intravenous hydromorphone 0.2 mg bolus. Hydromorphone consumption, pain scores during rest and movement, and any adverse effects were recorded at 1, 2, 6, 12, and 24 h after the operation.
Results: Overall hydromorphone consumption was significantly lower in group A compared with group C at all the time points (P = 0.013). The total 24-h hydromorphone consumption was reduced by 30% in group A. There was no significant difference in pain scores. The incidence of postoperative nausea and vomiting after the operation were significantly lower in group A than in group C (P < 0.05).
Conclusions: Premedication with acetaminophen reduced hydromorphone consumption and opioid-related side effect in patients undergoing abdominal hysterectomy, but did not significantly reduce pain intensity.
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http://dx.doi.org/10.1007/s00404-011-1860-7 | DOI Listing |
Pain Physician
December 2024
Department of Anesthesiology, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ.
Background: Poorly controlled acute breast surgery postoperative pain is associated with delayed recovery, increased morbidity, impaired quality of life, and prolonged opioid use during and after hospitalization. Recently, ultrasound-guided pectoralis nerve (PECS) I block and serratus anterior plane (SAP) block, together or individually, have emerged as a potential method to relieve pain, decrease opioid requirements, and improve patient outcomes.
Objective: The aim of this study was to assess if the addition of a PECS I/SAP block in patients undergoing bilateral mastectomies provides more effective perioperative analgesia compared to standard analgesia.
J Cardiothorac Vasc Anesth
November 2024
Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic; Phoenix, AZ. Electronic address:
Objectives: To evaluate whether the addition of ketamine to intraoperative methadone is associated with superior postoperative pain management and decreased opioid consumption compared with methadone alone in cardiac surgery patients.
Design: A retrospective cohort study.
Setting: A large academic medical system comprising four sites.
J Pain Res
November 2024
Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, NY, USA.
Purpose: To evaluate the impact of bilateral ultrasound-guided erector spinae plane blocks (ESPBs) on pain and opioid-related outcomes in a surgical population with chronic pain.
Methods: A retrospective, observational cohort study. Clinical data were extracted from the electronic medical records of patients who underwent lumbar fusion (February 2018 - July 2020).
J Opioid Manag
November 2024
Department of Anesthesiology, Weill Cornell Medicine, New York, New York.
Cureus
September 2024
Anesthesiology, Western University, London, CAN.
Introduction Video-assisted thoracic surgery (VATS) is a minimally invasive surgical technique though effective analgesia remains a challenge. Erector spinae plane block (ESPB) has gained popularity due to its ease and safety of placement. In this study, we evaluated the analgesic efficacy of ESPB in patients undergoing VATS through a propensity score-matched retrospective cohort study.
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