The analgesic efficacy of IV acetaminophen for acute postoperative pain in C-section patients: a randomized, double-blind, placebo-controlled study
The analgesic efficacy of IV acetaminophen for acute postoperative pain in C-section patients: a randomized, double-blind, placebo-controlled study
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DOI：
10.1080/14767058.2020.1735337
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发表时间：
2020-03-10
影响因子：
1.8
通讯作者：
Nair, Singh
中科院分区：
文献类型：
--
作者：
Bernstein, Jeffrey;Spitzer, Yelena;Nair, Singh
背景：美国剖宫产率呈上升趋势。满意的术后镇痛仍然是剖宫产的首要任务。减少阿片类药物消耗和提高患者满意度的多模式镇痛是麻醉医师照顾这一患者群体的目标。我们的研究旨在评估在24小时内四次静脉注射对乙酰氨基酚是否能降低剖宫产患者的疼痛评分和阿片类药物需求。方法：66例择期剖宫产患者在高压布比卡因12 mg、芬太尼10 μ g、无保存剂吗啡150 μ g的脊髓麻醉下，术后24 h随机给予对乙酰氨基酚静脉注射或安慰剂静脉注射，连续4次。术后24小时和48小时，盲法研究人员对吗啡等效性、疼痛评分、患者满意度和副作用进行了评估。结果：对乙酰氨基酚组与安慰剂组在24小时对阿片类药物的需求没有差异，分别为44.32 +/- 23 mg和47.59 +/- 28 mg （p = .607）。48小时也没有差异，57.95 +/- 20 mg和56.59 +/- 22 mg （p = .795）。两组患者术后疼痛评分、患者满意度和不良事件相似。结论：本研究的结果未能证明给予多剂量静脉对乙酰氨基酚治疗CS手术患者术后疼痛并接受鞘内吗啡作为麻醉和镇痛的一部分的任何额外益处。试验注册号：NCT02069184
Background: The rate of cesarean delivery is on the rise in the USA. Satisfactory postoperative analgesia remains a top priority for cesarean delivery. Multimodal analgesia with a reduction in opioid consumption and improvement in patient satisfaction is a goal for anesthesiologists caring for this patient population. Our study sought to assess whether IV acetaminophen in four divided doses over 24 h decreased pain scores and opioid requirements in patients undergoing cesarean delivery with neuraxial anesthesia. Methods: 66 patients undergoing elective cesarean delivery under spinal anesthesia with hyperbaric bupivacaine 12 mg, fentanyl 10 mu g, and preservative-free morphine 150 mu g were randomized to receive either IV acetaminophen or IV placebo for four consecutive doses in the first 24 h postoperatively. The need for rescue medication using morphine equivalence, pain scores, patient satisfaction, and side effects were assessed by a blinded researcher in the first 24 and 48 h postoperatively. Results: There was no difference in opioid requirements in the acetaminophen versus placebo group, 44.32 +/- 23 mg versus 47.59 +/- 28 mg (p = .607), respectively at 24 h. There was also no difference at 48 h, 57.95 +/- 20 mg versus 56.59 +/- 22 mg (p = .795). Postoperative pain scores, patient satisfaction, and adverse events were similar in both groups as well. Conclusions: The results of this study failed to demonstrate any additional benefits of administering multiple doses of IV acetaminophen for treating postoperative pain in patients who have undergone CS surgery and receiving intra-thecal morphine as part of their anesthesia and analgesia. Trial Registry number: NCT02069184