There is limited research on the clinical outcome differences between intravenous (IV) acetaminophen versus oral (PO) acetaminophen. With the costs of intravenous acetaminophen sometimes being almost 100 times the cost of PO acetaminophen, it is not only important fiscally but also clinically to differentiate the benefits of IV vs PO acetaminophen. The proposed research study is to determine the clinical advantages of IV vs PO acetaminophen during the post-operative recovery time for ambulatory surgery patients by analyzing differences in time to first opioid delivery, pain scores, and patient satisfaction.
In previous literature it has been shown that compared to placebo, IV acetaminophen can improve postoperative pain scores and reduce opioid requirements. In addition, IV acetaminophen has several pharmacokinetic properties that may be beneficial when compared to acetaminophen. IV acetaminophen has been shown to achieve a more rapid and higher maximum plasma concentration as well as higher cerebrospinal fluid concentrations. Comparative effectiveness trials of IV vs PO administration have not conclusively demonstrated improved clinical outcomes despite the proposed pharmacokinetic benefits. More research needs to be conducted to determine possible clinical advantages.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
103
1000mg of IV acetaminophen
oral acetaminophen 975mg pills
placebo match to acetaminophen
Mount Sinai West Hospital
New York, New York, United States
PACU Visual Analogue Pain Scores
Post-Anesthesia Care Unity (PACU) pain scores at baseline, 1 hour, and on discharge from PACU. Pain score by visual analogue score, total scale from 0 to 10 with 10 being the worse pain.
Time frame: baseline, 1 hour, and Day 1 discharge
Total MME Intraoperatively
Total Morphine Milligram Equivalent (MME) use intraoperatively
Time frame: Day 1
Total Narcotic Use in PACU.
Total narcotic use in PACU expressed in total morphine milligram equivalents (MME)
Time frame: Day 1
PACU Length of Stay
Time in PACU
Time frame: up to 24 hours after PACU arrival
Patient Reported Total Narcotic Use Post-discharge
home opiod use
Time frame: average 7 days
Patient Satisfaction.
Patient satisfaction total scale from 1 to 10, with higher score indicating more satisfaction
Time frame: 7 days post surgery
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Intravenous saline