Intravenous Acetaminophen for Perioperative Pain Control in Adult Elective Neurospine Surgical Patients: A Retrospective Case-Control Study

Fengyan Deng; Susan D Horn; Randall J Smout; Joanne V Hickey; Joseph J Naples

Intravenous Acetaminophen for Perioperative Pain Control in Adult Elective Neurospine Surgical Patients: A Retrospective Case-Control Study

AANA J. 2017 Jun;85(3):181-188.

Authors

Fengyan Deng¹, Susan D Horn², Randall J Smout³, Joanne V Hickey⁴, Joseph J Naples⁵

Affiliations

¹ received her master's degree in nurse anesthesia from the University of Pittsburg School of Nursing, Pittsburgh, Pennsylvania, in 2009. She received her doctoral degree in nursing practice (DNP) from the University of Texas Health Science Center at Houston School of Nursing, Houston, Texas, in 2014. She has been working as a Certified Registered Nurse Anesthetist for more than 5 years at Houston Methodist Hospital in the Texas Medical Center, Houston, Texas. Her current employer is United States Anesthesia Partners.
² is an adjunct professor in the Department of Population Health Sciences, Health Services Innovation and Research Program, University of Utah School of Medicine, Salt Lake City, Utah. She also is an adjunct professor in the Departments of Biomedical Informatics, University of Utah School of Medicine, and University of Utah College of Nursing, Salt Lake City, Utah.
³ is the senior clinical outcomes analyst at Primary Children's Hospital in Salt Lake City, Utah.
⁴ is affiliated with the University of Texas Health Science Center at the Houston School of Nursing.
⁵ is the chairman of the Department of Anesthesiology at Houston Methodist Hospital, Houston, Texas, and professor of clinical anesthesiology at Weill Cornell Medical College.

PMID: 31566554

Abstract

Adding intravenous (IV) acetaminophen to an opioid-based regimen as multimodal pain management for perioperative pain control in adults undergoing spine surgery can lead to effective pain control, reduce the risk of opioid-related adverse effects, and facilitate postoperative neurologic evaluation for surgical outcomes. This descriptive pilot study investigated the analgesic effect of a single dose of IV acetaminophen administered intraoperatively as routine practice for perioperative pain management for adults undergoing elective spine surgery. A retrospective comparative cohort study compared an IV acetaminophen group with a group not receiving IV acetaminophen for primary outcomes measured by visual analog scale (VAS) and associated secondary outcomes. The IV acet-aminophen group had lower mean VAS scores than the group not receiving IV acetaminophen (4.33 vs 6.22, P = .01, at 60 minutes after entry into the postanesthesia care unit [PACU] for procedure level 4; 2.43 vs 3.11, P = .002, at PACU discharge for procedure level 3). The study did not show consistently lower VAS scores for the IV acetaminophen group vs the group not receiving IV acetaminophen. No difference was found for other secondary outcomes between groups. Future prospective studies are needed to assess the analgesic effects of IV acetaminophen for spine surgery cases.

Keywords: Acute surgical pain; intravenous acetaminophen; multimodal analgesia; perioperative pain; spine surgery.