Newswise — Use of perioperative intravenous (IV) acetaminophen for minimally invasive spine surgery has no effect on intraoperative or postoperative opioid use or pain score, according to a study from the School of Medicine at the University of Southern California in Los Angeles, CA.

Marie Le Clair and Eugenia Ayrian Keck received a Resident/Fellow Travel Award for their abstract of the study, “The Effect of Perioperative IV Acetaminophen Administration on Intraoperative and Postoperative Opioid Use and Pain Scores in Minimally Invasive Spine Surgery,” which will be presented on Thursday, April 11, 2019, during the 44th Annual Regional Anesthesiology and Acute Pain Medicine Meeting in Las Vegas, NV.

Opioid pain medications are widely used for intraoperative and postoperative analgesia yet carry significant side effects. To determine whether perioperative IV acetaminophen can reduce opioid use during and after spine surgery, the researchers conducted a retrospective chart review of 187 patients divided into two groups: those who received IV acetaminophen during surgery and those who did not. As a subset of the IV acetaminophen group, they also compared patients who received it in the first hour after surgical incision to those who received it after the first hour of surgery.

The total dose of opioid administered during surgery and after surgery was not significantly different between the acetaminophen and non-acetaminophen groups (p = 0.75). Total postoperative day 0 and postoperative day 1 opioid use also did not differ significantly between the two groups (p = 0.17), nor did initial, maximum, nor mean postoperative pain scores (p = 0.16, p = 0.25, and p = 0.35, respectively). In the acetaminophen group, the researchers saw no differences across the outcomes measured between patients who had received acetaminophen in the first hour of surgery or after the first hour of surgery.

“Our results do not show an effect of perioperative IV acetaminophen on intraoperative or postoperative opioid use or pain scores in minimally invasive spine surgeries,” the authors explained. “Although previous literature supports the benefit of including multimodal analgesia as part of an intraoperative pain management plan, our results failed to identify a measurable effect of perioperative acetaminophen alone on opioid requirements or pain scores.”

They said that IV acetaminophen may benefit a carefully selected subset of patients undergoing surgery, but more research is needed to identify appropriate patient criteria. The authors said that particularly in light of IV acetaminophen’s high cost and low availability, it is not necessary for an average patient undergoing minimally invasive spine surgery.

The 44th Annual Regional Anesthesiology and Acute Pain Medicine Meeting will be held April 11–13, 2019, in Las Vegas, NV. The conference brings together worldwide experts in acute pain medicine to discuss standard and novel techniques, new pain targets, and strategies to address the opioid epidemic.

 

Meeting Link: 44th Annual Regional Anesthesiology and Acute Pain Medicine Meeting, April 11–13, 2019