Does Intravenous Acetaminophen Improve Postoperative Pain Control after Laparoscopic Appendectomy for Perforated Appendicitis? A Prospective Randomized Trial.

Creator(s)

Richard Sola, Children's Mercy Hospital
Amita A. Desai, Children's Mercy Hospital
Katherine W. Gonzalez, Children's Mercy Hospital
Nichole M. Doyle, Children's Mercy HospitalFollow
Katrina L. Weaver, Children's Mercy HospitalFollow
Ashwini S. Poola, Children's Mercy Hospital
Jason D. Fraser, Children's Mercy HospitalFollow
Shawn D. St Peter, Children's Mercy HospitalFollow
Daniel L. Millspaugh, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

4-1-2019

Identifier

DOI: 10.1055/s-0037-1615276

Abstract

INTRODUCTION:  The recent increased awareness of the dangers of opioids in the United States has highlighted the need to minimize narcotics and identify nonopioid options for pain control after surgery. With evidence suggesting that intravenous acetaminophen (IVA) can be an opioid sparing option, we conducted a prospective, randomized trial that evaluated the effect of IVA on the postoperative pain course of children with perforated appendicitis.

MATERIALS AND METHODS:  After IRB approval, children with perforated appendicitis were randomized to receive postoperative IVA with the standard patient/nurse-controlled analgesia (PCA) or to receive the PCA alone. All patients were treated according to an evidence-based treatment protocol. The primary outcome was duration of time on PCA.

RESULTS:  Eighty-two patients were analyzed from 7/14 to 11/15. There was no statistically significant difference in the time to transition from the PCA to oral pain medications for children given IVA compared with children not receiving IVA (76.4 ± 32.5 versus 86.7 ± 49.3 hours;

CONCLUSION:  Children given IVA showed no difference in the transition time off the PCA and to oral pain medications after laparoscopic appendectomy for perforated appendicitis.

Journal Title

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie

Volume

29

Issue

2

First Page

159

Last Page

165

MeSH Keywords

Acetaminophen; Administration, Oral; Adolescent; Analgesia, Patient-Controlled; Analgesics, Non-Narcotic; Analgesics, Opioid; Appendectomy; Appendicitis; Child; Child, Preschool; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Laparoscopy; Male; Pain, Postoperative; Prospective Studies; Single-Blind Method; Treatment Outcome

Recommended Citation

Sola R Jr, Desai AA, Gonzalez KW, et al. Does Intravenous Acetaminophen Improve Postoperative Pain Control after Laparoscopic Appendectomy for Perforated Appendicitis? A Prospective Randomized Trial. Eur J Pediatr Surg. 2019;29(2):159-165. doi:10.1055/s-0037-1615276