Comparison of intravenous and oral administration of acetaminophen in adults undergoing general anesthesia

Abstract

Background Acetaminophen is a widely clinically used analgesic. However, the clinical effect of the route of administration on postoperative analgesia as well as on postoperative nausea and vomiting in patients undergoing general anesthesia remains unclear. This study aimed to explore whether the route of administration of acetaminophen affects postoperative analgesia, nausea, and vomiting in patients undergoing general anesthesia. Methods We included all randomized controlled trials investigating the effects of the route of administration of acetaminophen on postoperative pain, nausea, and vomiting in patients undergoing general anesthesia. Independent examiners reviewed the literature and extracted data, with disagreements resolved through negotiation or the involvement of a third party. The Cochrane risk assessment tool was used to evaluate the quality of the included randomized controlled trials. A narrative synthesis was conducted to summarize the qualitative information from the included studies. A meta‐integration of quantitative data was performed using RevMan 5.4. Results Ten studies met the inclusion criteria. Eight studies assessed postoperative pain, whereas two assessed postoperative nausea and vomiting. Data from the eight studies assessing postoperative pain confirmed that there was no difference between intravenously and orally administered acetaminophen in adults (OR = −0.13; 95% CI, −0.36 to 0.11; p = 0.3). Data from the two studies assessing postoperative nausea and vomiting revealed no difference between intravenously and orally administered acetaminophen in adults (OR = 0.89; 95% CI, 0.64–1.25; p = 0.51). The included studies were of poor quality, with a heterogeneity of 68%. Conclusions No differences in postoperative analgesia or postoperative nausea and vomiting were observed between the routes of administration (intravenous vs. oral) of acetaminophen in adult patients undergoing general anesthesia. There is a need for future large sample studies to increase the reliability of the results.

Actualización en alternativas para control del dolor posoperatorio en cirugía plástica

“…Las técnicas analgésicas se han modificado para llevar este manejo al ámbito domiciliario del paciente y, en este grupo seleccionado de pacientes, la posibilidad de realizar analgesia invasiva domiciliaria como gran avance en el control del dolor es contundente. El uso de técnicas regionales continuas podría simplificar el tratamiento y ahorrar costos de enfermería [5], [6], [7].…”