A Randomized Study on The Prophylactic Use of Acetaminophen to Prevent Fever After The Removal of Drainage Tubes in Lumbar Surgery

Abstract

Study design: a prospectively random clinical trialObjective: To explore the efficacy of prophylactic use of Acetaminophen in preventing fever after the removal of tube drainage in lumbar surgery.Summary and background data: Many inpatients encountered a fever in the first 24 hours when the drainage tube was removed. When fevers appeared, it was costly to exclude the possibility of deep infection and always failed to identify the etiology. Just like the postoperative fever, we suggested that the fever was caused by the normal inflammatory response, and tried to figure out whether the prophylactic use of Acetaminophen could lower the possibility of fever or not.Methods: 183 consecutive patients undergoing lumbar spine surgery were prospectively randomized into 2 groups. 91 patients were allocated into the study group, they would receive a pill of Acetaminophen (Tylenol, 650mg) before the removal of lumbar tube drainage, and another one at 8p.m. The rest 92 patients were divided into the control group, they were treated in routine treatment without Acetaminophen. In the first 24 hours, a temperature higher than 37.7°C was defined as fever. The 2 groups were then compared for differences in age, gender, height, weight, body mass index (BMI), surgical segments, surgical time, blood loss, blood transfusion, American Society of Anesthesiologists (ASA) score, duration of the tube drainage, total volume of the drainage collection, variation of the levels of WBC, CRP, hospital stay since the removal of drainage to discharge and the rate of fever.Results: There were no differences in all the basic information of 2 groups, but the fever rate of the 2 groups had significant differences (P=0.006), the fever rate of the study group (14/91, 15.38%) was significant lower than the control group (30/92, 32.61%).Conclusion: Fever after the removal of tube drainage was caused by normal inflammation response, and a small dose of acetaminophen could significantly lower the possibility fever. Trail registration: This trail was registered in the ClinicalTrial.gov PRS on July 13, 2019, and the ID was NCT04042948.