TY - JOUR
T1 - Effect of single dose intraoperative IV acetaminophen in pediatric tonsillectomy or adenotonsillectomy
AU - Roberts, Christopher A.
AU - Shah-Becker, Shivani
AU - Derr, Jonathan B.
AU - Sedeek, Khaled
AU - Carr, Michele M.
N1 - Publisher Copyright:
© 2016
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background A number of different treatment regimens have been described for post-operative pain management for pediatric tonsillectomy following the widespread discontinuation of the use of codeine due to safety concerns. However, the literature is lacking with regard to the relative efficacy of the treatment regimens. This study is designed to determine the effectiveness of an intraoperative dose of intravenous acetaminophen for pediatric tonsillectomy pain management. Methods Records were reviewed for pediatric patients undergoing tonsillectomy with a single surgeon between 2012 and 2014. Pain scores, need for narcotic analgesics, and recovery times were reviewed for up to 24 postoperative hours. Patients were grouped based on whether they received an intraoperative dose of intravenous acetaminophen (Group 1) or did not receive it (Group 2). The primary outcome measure was pain score during the 24-h post-operative period. Secondary outcome measures include need for narcotic medications for breakthrough pain in the recovery room and time spent in the recovery room and hospital. Results 350 patients were included, of which 116 received an intraoperative dose of intravenous acetaminophen. Patients in Group 1 had lower pain scores during the second postoperative hour (1.27 vs. 2.06, p = 0.008). No significant differences were noted for pain scores during postoperative hours 1 or 3–24. Patients in Group 1 spent less time in the Recovery Room (59.08 min vs. 69.5 min, p = 0.016) but more time in the hospital (24.54 h vs. 19.66 h, p = 0.030). There was no difference between the groups based on whether the patients received narcotics for breakthrough pain in the recovery room (79.3% vs. 70.9%, p = 0.094). Conclusion Intraoperative intravenous acetaminophen may lead to improved pain scores in the early postoperative period and decreased time in the recovery room, but this group also had a longer hospital stay. This information should instigate randomized controlled trials of this intervention.
AB - Background A number of different treatment regimens have been described for post-operative pain management for pediatric tonsillectomy following the widespread discontinuation of the use of codeine due to safety concerns. However, the literature is lacking with regard to the relative efficacy of the treatment regimens. This study is designed to determine the effectiveness of an intraoperative dose of intravenous acetaminophen for pediatric tonsillectomy pain management. Methods Records were reviewed for pediatric patients undergoing tonsillectomy with a single surgeon between 2012 and 2014. Pain scores, need for narcotic analgesics, and recovery times were reviewed for up to 24 postoperative hours. Patients were grouped based on whether they received an intraoperative dose of intravenous acetaminophen (Group 1) or did not receive it (Group 2). The primary outcome measure was pain score during the 24-h post-operative period. Secondary outcome measures include need for narcotic medications for breakthrough pain in the recovery room and time spent in the recovery room and hospital. Results 350 patients were included, of which 116 received an intraoperative dose of intravenous acetaminophen. Patients in Group 1 had lower pain scores during the second postoperative hour (1.27 vs. 2.06, p = 0.008). No significant differences were noted for pain scores during postoperative hours 1 or 3–24. Patients in Group 1 spent less time in the Recovery Room (59.08 min vs. 69.5 min, p = 0.016) but more time in the hospital (24.54 h vs. 19.66 h, p = 0.030). There was no difference between the groups based on whether the patients received narcotics for breakthrough pain in the recovery room (79.3% vs. 70.9%, p = 0.094). Conclusion Intraoperative intravenous acetaminophen may lead to improved pain scores in the early postoperative period and decreased time in the recovery room, but this group also had a longer hospital stay. This information should instigate randomized controlled trials of this intervention.
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U2 - 10.1016/j.egja.2016.10.002
DO - 10.1016/j.egja.2016.10.002
M3 - Article
AN - SCOPUS:85006483799
SN - 1110-1849
VL - 33
SP - 97
EP - 101
JO - Egyptian Journal of Anaesthesia
JF - Egyptian Journal of Anaesthesia
IS - 1
ER -