A Randomized, Double-Blind, Placebo-Controlled, Multicenter, Repeat-Dose Study of Two Intravenous Acetaminophen Dosing Regimens for the Treatment of Pain After Abdominal Laparoscopic Surgery

Wininger, Steven J.; Miller, Howard J.; Minkowitz, Harold S.; Royal, Mike A.; Ang, Robert Y.; Breitmeyer, James B.; Singla, Neil

doi:10.1016/j.clinthera.2010.12.011

Cited by 120 publications

(94 citation statements)

References 20 publications

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“…More precisely, in a randomized trial, 88 patients were treated with 2 doses of 1 g of paracetamol for pain after laparoscopic surgery; efficacy was com- pared with 83 placebo-treated patients. Paracetamol achieved early relief from pain and the rate of decrease of VAS was similar to the one described in the present study (10). In another randomized study, 40 patients undergoing laparoscopic cholecystectomy were administered 1 g of intravenous paracetamol every 6 h on the first postoperative day followed by a similar oral dose regimen for 7 days.…”

Section: Discussionsupporting

confidence: 83%

Intravenous Paracetamol as an Antipyretic and Analgesic Medication: the Significance of Drug Metabolism

Giamarellos‐Bourboulis

Spyridaki

Savva

et al. 2014

J Pharmacol Sci

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Abstract.One prospective, open-label, non-randomized study was conducted in 100 patients to define the antipyretic and analgesic effect of a new intravenous formulation of 1 g of paracetamol; 71 received paracetamol for the management of fever and 29 received paracetamol for pain relief after abdominal surgery or for neoplastic pain. Serial follow-up measurements of core temperature and of pain intensity were done for 6 h. Additional rescue medications were recorded for 5 days. Blood was sampled for the measurement of free paracetamol (APAP) and of glucuronide-APAP and N-sulfate-APAP by an HPLC assay. Defervescence, defined as core temperature below or equal to 37.1°C, was achieved in 52 patients (73.2%) within a median time of 3 h. Patients failing to become afebrile with the first dose of paracetamol became afebrile when administered other agents as rescue medications. Analgesia was achieved in 25 patients (86.4%) within a median time of 2 h. Serum levels of glucuronide-APAP were greater among non-responders to paracetamol. The presented results suggest that the intravenous formulation of paracetamol is clinically effective depending on drug metabolism.

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Section: Discussionsupporting

confidence: 83%

Intravenous Paracetamol as an Antipyretic and Analgesic Medication: the Significance of Drug Metabolism

Giamarellos‐Bourboulis

Spyridaki

Savva

et al. 2014

J Pharmacol Sci

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“…Paracetamol (intravenous acetaminophen) is a non-opioid analgesic that is devoid of risks related to opioids (8,9). The postoperative use of paracetamol has been shown to decrease acute pain after various surgical procedures (10). Although there is few data on the analgesic affection of a preoperative (pre-emptive) administration of paracetamol (11,12), there are no data on the efficacy of the preventive (intraoperative or the end of surgery) administration of paracetamol on the postoperative pain.…”

Section: Introductionmentioning

confidence: 99%

Preventive Analgesia with Intravenous Paracetamol for Post-cesarean section Pain Control

Atashkhoyi¹,

Rasouli²,

Fardiazar³

et al. 2014

IJWHR

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Objectives: Effective pain therapy after cesarean section is essential for parturient comfort and to allow early ambulation to facilitate care of her infant. This study evaluated the analgesic effect of preventive 1gr intravenous paracetamol on postoperative pain and analgesic consumption during the 24 hours after cesarean section. Materials and Methods: One-hundred American Society of Anesthesiologists (ASA) I or II status parturient scheduled for elective cesarean section under spinal anesthesia. Patients received 1gr iv paracetamol into 100 ml normal saline (study group; n=50) or normal saline alone (placebo group; n=50) 20 minutes before the end of operation. Results: Pain scores were lower in the study group in the Post anesthesia care unit (PACU) (p<0.001) and up to 4h after operation (p<0.001). Cumulative analgesic consumption was lower in the study group (p<0.001). Conclusion: Preventive administration of 1gr iv paracetamol reduces the intensity of pain in the PACU and until 4h after operation and analgesic consumption following cesarean section.

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“…The most common adverse effects reported of any group were constipation, flatulence, nausea, and headache. This study concluded that both IVAPAP regimens (1 gram every six hours and 650 milligrams every four hours) were associated with significant pain relief compared with placebo and were well tolerated in abdominal laparoscopic surgical patients (Wininger et al, 2010). The assumption behind this theory is that there are sufficient commonalities among symptoms to warrant a theory that is not limited to one symptom, but can explain and guide research and symptoms (Lenz, Pugh, Milligan, Gift, & Suppe, 1997).…”

Section: Intravenous Acetaminophen: Role In Abdominal Surgeriesmentioning

confidence: 97%

“…under a brand name of Ofirmev, although it was widely available in Europe for more than a decade. Its' safety profile is supported by more than seven years of clinical post marketing safety experience outside the US and more than 60 years of clinical experience with oral and rectal acetaminophen (Wininger et al, 2010). The advantage of using IVAPAP in multimodal approach is that it is safe to use in conjunction with other drugs and has few clinically significant drug interactions.…”

Section: Intravenous Acetaminophen: Role In Postoperative Pain Managementioning

confidence: 99%

Intravenous Acetaminophen use in Postoperative Pain Management

Kumar¹

2014

Preprint

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Surgery is a most common source of acute pain and effective postoperative pain management is crucial for wound healing and recovery. Opiods are the mainstay for acute pain management but have various adverse effects including death. The multimodal approach involves the use of multiple drugs with varying mechanism of action to achieve optimal pain relief with less adverse effects. Intravenous acetaminophen (IVAPAP) is a new addition to the multimodal approach that appears to afford effective pain relief with a low risk profile. The purpose of this research study was to examine the impact of IVAPAP use in multimodal pain management on decreased opioid consumption and decreased average length of hospital stay in the post colectomy population. A comparative two group retrospective chart review was conducted, with a total of 72 charts meeting the inclusion criteria. Group 1(n=36) study subjects who received IVAPAP for pain management were compared to Group 2(n=36) subjects who had not received IVAPAP after colectomy. Results demonstrated that Group 1, those who had received IVAPAP, used less opioids during the postoperative period as compared to those in Group 2 who had not received IVAPAP; there was no difference in length of stay between the groups. Further research related to the use of multimodal pain management strategies in general, and related to IVAPAP in particular, is indicated. Recommendations and implications for advanced practice nursing are presented and discussed.Keywords: pain, postoperative pain, postoperative pain management, acetaminophen injection, abdominal surgery and IV acetaminophen, colectomy and postoperative pain. Acknowledgement

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A Randomized, Double-Blind, Placebo-Controlled, Multicenter, Repeat-Dose Study of Two Intravenous Acetaminophen Dosing Regimens for the Treatment of Pain After Abdominal Laparoscopic Surgery

Cited by 120 publications

References 20 publications

Intravenous Paracetamol as an Antipyretic and Analgesic Medication: the Significance of Drug Metabolism

Intravenous Paracetamol as an Antipyretic and Analgesic Medication: the Significance of Drug Metabolism

Preventive Analgesia with Intravenous Paracetamol for Post-cesarean section Pain Control

Intravenous Acetaminophen use in Postoperative Pain Management

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