A new postoperative pain management (intravenous acetaminophen: Acelio®) leads to enhanced recovery after esophagectomy: a propensity score-matched analysis
To investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance the recovery after esophagectomy.
A propensity score-matched population was created using the 93 and 69 consecutive patients who underwent esophagectomy for esophageal cancer before and after the introduction of postoperative scheduled intravenous acetaminophen, and the short-term clinical outcomes were compared.
Significant defervescence was demonstrated in the Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (p < 0.05), whereas no significant differences were observed in the postoperative inflammatory parameters. The incidence of postoperative complications was similar between the groups. The number of PCA pushes and the frequency of using other non-opioid analgesics were significantly smaller in the A-group than in the C-group (p < 0.05). Both daily and cumulative opioid uses were significantly smaller in the A-group than in the C-group (p < 0.05). The time to first flatus was significantly shorter in the A-group than in the C-group (p < 0.001). The day of first walking after surgery was significantly earlier in the A-group than in the C-group (1.0 versus 2.0 days, p = 0.003). The ICU stay (2.86 versus 3.61 days, p < 0.001) and the hospital stay (21.5 versus 26.0 days, p = 0.061) tended to be shorter in the A-group than in the C-group.
Postoperative scheduled intravenous acetaminophen decreased the rate of opioid use without increasing the intensity of postoperative pain and may be a feasible new pain management option in the enhanced recovery after surgery protocol following esophagectomy.
KeywordsEsophageal cancer Acetaminophen Pain management Propensity score matching ERAS
We thank Dr. Erika Ohkura for her English proofreading of our manuscript.
Study conception: YO, JS, and MU. Data accumulation: all authors. Data analysis: YO, JS, and MU. Writing of the manuscript: all authors. Critical revision: YO, JS, MU, and HU.
Compliance with ethical standards
Written informed consent was obtained from all of the patients for the publication of this report.
Conflict of interest
All authors have no conflicts of interest or financial ties to disclose.
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