Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial

Laryngoscope Investigative Otolaryngology

article

Ravi Bhoja¹  Matthew W. Ryan²  Kevin Klein¹  Abu Minhajuddin¹  Emily Melikman¹  Mohamed Hamza¹  Bradley F. Marple²  David L. McDonagh¹ 

[1] Department of Anesthesiology and Pain Management, The University of Texas Southwestern;Department of Otolaryngology, The University of Texas Southwestern

关键词: acetaminophen;    analgesia;    functional endoscopic sinus surgery;    intravenous;    oral;    postoperative pain;    sinus surgery;   

DOI  :  10.1002/lio2.375

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Background: Multimodal perioperative analgesia including acetaminophen is recommended by current guidelines. The comparative efficacy of intravenous vs oral acetaminophen in sinus surgery is unknown. We aimed to determine whether intravenous or oral acetaminophen results in superior postoperative analgesia following sinus surgery. Methods: This was a prospective randomized trial with blinded endpoint assessments conducted at a single large academic medical center. Subjects undergoing functional endoscopic sinus surgery were randomized to intravenous vs oral acetaminophen in addition to standard anesthetic and surgical care. The primary outcome was visual analogue scale pain score at 1 hour postoperatively. Results: One hundred and ten adult patients were randomized; 9 were excluded from the data analysis. Fifty patients were assigned to intravenous acetaminophen and 51 to oral acetaminophen. Postoperative pain scores at 1 hour (primary endpoint) were not significantly different between the intravenous and oral acetaminophen groups. Similarly, there was no significant difference in pain scores at 24 hours postoperatively. Finally, there was no significant difference in postoperative opioid usage in the postanesthesia care unit or over the first 24 hours postoperatively. Conclusions: This is the first comparative efficacy trial of oral vs intravenous acetaminophen in sinus surgery. There was no significant difference in pain scores at 1 or 24 hours postoperatively, and no difference in postoperative opioid use. Intravenous acetaminophen offers no apparent advantage over oral acetaminophen in patients undergoing sinus surgery.

【 授权许可】

CC BY|CC BY-NC-ND