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Intravenous Acetaminophen for the Management of Short-Term Post-Operative Pain: A Review of Clinical Effectiveness and Cost-Effectiveness

Published on: October 12, 2018
Project Number: RC1023-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of intravenous acetaminophen for patients with post-operative pain?
  2. What is the cost-effectiveness of intravenous acetaminophen for patients with post-operative pain?

Key Message

Evidence identified from seven systematic reviews was limited in methodological quality and was heterogeneous regarding patient populations, comparators, and time and duration of intravenous acetaminophen administration. One SR found that IV acetaminophen was superior to placebo in the proportion of adult patients undergoing any surgical procedure achieving at least 50% pain relief four or six hours after administration of IV medication. The remaining findings measuring difference in pain scores at various points in the post-operative period were inconsistent, therefore limiting the ability to draw firm conclusions. There was no significant difference in pain scores comparing IV acetaminophen to placebo in adult patients undergoing abdominal surgery.There was no evidence to show that IV acetaminophen performed better than active comparators such as IV NSAIDs or IV opioids. There was a consistent trend amongst studies showing an overall decrease in opioid consumption with the use of IV acetaminophen; however the magnitude of this decrease is unknown (and thus clinical significance is also unknown). There was no difference found in hospital length of stay when adding IV acetaminophen.No studies on the cost-effectiveness of IV acetaminophen peri-operatively or immediately post-operatively were identified and the clinical studies mainly focused on short-term outcomes.

Tags

pain management, acetaminophen, infusions, intravenous, Acetaminophen, paracetamol, Tylenol, intravenous drug delivery system, Postsurgery, pain management