The role of intravenous acetaminophen in multimodal pain protocols for perioperative orthopedic patients.

@article{Lachiewicz2013TheRO,
  title={The role of intravenous acetaminophen in multimodal pain protocols for perioperative orthopedic patients.},
  author={Paul F Lachiewicz},
  journal={Orthopedics},
  year={2013},
  volume={36 2 Suppl},
  pages={
          15-9
        }
}
Multimodal pain management should be considered for all perioperative orthopedic patients. The goal of reducing the amount of perioperative opioid medication given may be achieved by using nonopioid medications, including intravenous acetaminophen. The site of action of acetaminophen is a variety of receptors in the central nervous system. When given intravenously, acetaminophen produces a much higher plasma concentration, which then leads to higher levels in the cerebrospinal fluid. The safety… 
Multimodal therapy in perioperative analgesia.
Is Scheduled Intravenous Acetaminophen Effective in the Pain Management Protocol of Geriatric Hip Fractures?
TLDR
The utilization of scheduled IV acetaminophen as part of a standardized pain management protocol for geriatric hip fractures resulted in shortened length of hospital stay, decreased pain levels and narcotic use, fewer missed PT sessions, and higher rate of discharge to home.
Implementing Recommended Perioperative Pain Practice Guidelines by Incorporating Intravenous Acetaminophen
TLDR
Findings support current literature review that IVA is an effective nonanalgesic for perioperative pain management and recommend it as part of multimodal analgesia at an acute care hospital in Northern Arizona.
Reduction of Postoperative Pain by Addition of Intravenous Acetaminophen after Total Hip Arthroplasty: A Retrospective Cohort Study.
TLDR
The addition of IV APAP to the current standard multimodal analgesia protocol for Japanese patients who have undergone a total hip arthroplasty may decrease the patients' postoperative pain.
Effect of intravenous acetaminophen on post-operative opioid-related complications: study protocol for a randomized, placebo-controlled trial
TLDR
The primary hypothesis is that total duration of hypoxia (defined as saturation of peripheral oxygen (SpO 2 ) < 90%) is less in patients receiving intravenous acetaminophen than placebo, which is expected to accurately assess opioid-related complications after major abdominal surgery and provide reliable results correlated with opioid use.
Pain Management for Ambulatory Surgery: What Is New?
Safe ambulatory surgery mandates the provision of an anesthetic ‘package’, or care bundle commensurate with surgery, which enables the patient (or their guardian) to manage their pain at home.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 35 REFERENCES
Multimodal analgesia for controlling acute postoperative pain
TLDR
There is a continuing need to explore new drug combinations to achieve all of the purported goals of multimodal anesthesia.
Efficacy and Safety of Single and Repeated Administration of 1 Gram Intravenous Acetaminophen Injection (Paracetamol) for Pain Management after Major Orthopedic Surgery
TLDR
Intravenous acetaminophen, 1 g, administered over a 24-h period in patients with moderate to severe pain after orthopedic surgery provided rapid and effective analgesia and was well tolerated.
INTRAVENOUS PARACETAMOL IS AS EFFECTIVE AS MORPHINE IN KNEE ARTHROSCOPIC DAY SURGERY PROCEDURES
TLDR
Both intravenous Paracetamol and Intravenous Morphine seems to have the same analgesic effect in postoperative pain control of patients undergoing knee arthroscopic surgery as day cases, however, side effects with IntraVENous Par acetamol were much less.
Intravenous Paracetamol Improves the Quality of Postoperative Analgesia but Does not Decrease Narcotic Requirements
TLDR
Although repeated IV paracetamol usage after lumbar laminectomy and discectomy did not demonstrate a significant opioid-sparing effect, it did decrease visual analog scale scores at certain evaluation times and incidence of vomiting and increase patient satisfaction.
Multi-modal, pre-emptive analgesia decreases the length of hospital stay following total joint arthroplasty.
TLDR
Patients undergoing total joint arthroplasty who received either postoperatively patient-controlled analgesia or pre-emptive analgesia had a decreased hospital length of stay and reduced likelihood of discharge to a skilled nursing facility, and data support the continued study and use of pre-emption multi-modal analgesia paradigms in this population.
Periarticular Local Anesthesia does not Improve Pain or Mobility after THA
TLDR
Periarticular infiltration of local anesthetic during THA did not reduce postoperative pain or length of hospital stay and did not improve early postoperative mobilization.
Randomised Controlled Trial Comparing Oral and Intravenous Paracetamol (Acetaminophen) Plasma Levels when given as Preoperative Analgesia
TLDR
It can be concluded that paracetamol gives more reliable therapeutic plasma concentrations when given intravenously than orally when given as premedication.
Randomised comparison of intravenous paracetamol and intravenous morphine for acute traumatic limb pain in the emergency department
TLDR
Intravenous paracetamol appears to provide a level of analgesia comparable to intravenous morphine in isolated limb trauma in patients with moderate to severe traumatic limb pain.
Practice Guidelines for Acute Pain Management in the Perioperative Setting: An Updated Report by the American Society of Anesthesiologists Task Force on Acute Pain Management
TLDR
Practice Guidelines developed by the American Society of Anesthesiologists are not intended as standards or absolute requirements, and their use cannot guarantee any specific outcome.
...
1
2
3
4
...