Effect of preemptive and preventive acetaminophen on postoperative pain score: a randomized, double-blind trial of patients undergoing lower extremity surgery

Khalili, Gholamreza; Janghorbani, Mohsen; Saryazdi, Hamid; Emaminejad, Abbas

doi:10.1016/j.jclinane.2012.09.004

Cited by 82 publications

(47 citation statements)

References 31 publications

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“…Thus, if detection of painful stimuli is prevented during surgery, the postoperative pain should be minimized. We therefore, share the view of other authors [31,32] that the preemptive treatment of postoperative pain may substantially reduce the analgesic requirement after surgery. Another possible explanation would be the potent analgesic effect of the metabolite of paracetamol.…”

Section: Discussionsupporting

confidence: 75%

“…Tsang and colleagues [30] noted a satisfactory pain relief together with a remarkable opioid-sparing effect in 47 preoperative patients with traumatic hip fracture, who were given regular doses of IV paracetamol. In a recent study involving 75 patients who underwent lower limb surgery under spinal anesthesia, Khalili and his colleagues [31] compared the use of a single IV infusion of paracetamol 15 mg kg -1 as a preemptive analgesic (given half an hour preoperatively) or as a preventive analgesia (given prior to skin closure). They observed that both preemptive and preventive paracetamol administrations were effective, enhanced the postoperative analgesia and reduced the need for rescue analgesics.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative paracetamol infusion reduces sevoflurane consumption during thyroidectomy under general anesthesia with spectral entropy monitoring

Abdelmageed

Taher

2014

Egyptian Journal of Anaesthesia

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Background: Intravenous (IV) paracetamol has a significant opioid-sparing effect. We investigated the effect of paracetamol infusion on sevoflurane consumption during entropy monitored general anesthesia. Methods: Sixty-two ASA I and II patients undergoing thyroidectomy under general anesthesia were included in a prospective, randomized, double-blind and placebo controlled study. The patients were randomized to receive a slow infusion of either 1 g paracetamol (paracetamol group, n = 31) or saline (control group, n = 31) just before induction of anesthesia. Sevoflurane concentration was titrated to keep the state entropy value between 40 and 50. End-tidal sevoflurane concentration, sevoflurane consumption, recovery characteristics, time to first analgesic request and meperidine consumption during the first 6 postoperative hours were recorded. Results: The mean ± SD estimated sevoflurane consumption was significantly lower in the paracetamol treated patients (36.2 ± 15 vs 44.9 ± 13.9 ml, in the control group; p = 0.021). Patients receiving paracetamol had a faster post-anesthetic recovery profile (extubation time, time to eye opening to command and time to state name and mention his/her home address) than the other

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Preoperative paracetamol infusion reduces sevoflurane consumption during thyroidectomy under general anesthesia with spectral entropy monitoring

Abdelmageed

Taher

2014

Egyptian Journal of Anaesthesia

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“…Like NSAIDs, paracetamol enhances analgesia and produces an opioid-sparing effect, reducing postoperative postoperative nausea and vomiting (PONV) and sedation (32)(33)(34)(35). It is well tolerated and not burdened by NSAID-like side effects.…”

Section: Paracetamolmentioning

confidence: 99%

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols

Piccioni¹,

Segat²,

Falini³

et al. 2018

J. Thorac. Dis.

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Enhanced Recovery After Surgery (ERAS) is a multimodal, multidisciplinary approach to surgical patients with the aim of enhancing the quality of recovery after surgery (1,2). This strategy translates into faster post-operative recovery and improvements of outcomes. All the ERAS Society guidelines (freely available at www.erassociety.org) take into consideration the perioperative management of analgesia. The role of pain management in ERAS pathways is fundamental, considering the importance of containing surgical stress, reducing pain-related complications and speeding recovery (2-5). Correspondence to: Carlo Del Naja, MD. Casa Sollievo della Sofferenza Hospital, viale Cappuccini, 1, 71013 San Giovanni Rotondo (FG), Italy.Email: c.delnaja@operapadrepio.it.Abstract: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors' experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy.

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“…Khalil et al [38] Randomized controlled trial period and provide better pain control than opioid analgesics alone. Additionally, there is fair (Grade B) evidence that short-term use of NSAID result in no long-term reduction in bone healing or fusion rates.…”

Section: Nsaidmentioning

confidence: 99%

Best evidence in multimodal pain management in spine surgery and means of assessing postoperative pain and functional outcomes

Devin

McGirt

2015

Journal of Clinical Neuroscience

203

133

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Effect of preemptive and preventive acetaminophen on postoperative pain score: a randomized, double-blind trial of patients undergoing lower extremity surgery

Cited by 82 publications

References 31 publications

Preoperative paracetamol infusion reduces sevoflurane consumption during thyroidectomy under general anesthesia with spectral entropy monitoring

Preoperative paracetamol infusion reduces sevoflurane consumption during thyroidectomy under general anesthesia with spectral entropy monitoring

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols

Best evidence in multimodal pain management in spine surgery and means of assessing postoperative pain and functional outcomes

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