Skip to main content

Advertisement

SpringerLink
Log in

Effectiveness of scheduled intravenous acetaminophen in the postoperative pain management of video-assisted thoracic surgery

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The scheduled administration of intravenous acetaminophen (scheduled-IV-AcA) is one of the more effective multimodal analgesic approaches for postoperative pain in abdominal/orthopedic surgeries. However, there is little evidence concerning scheduled-IV-AcA after general thoracic surgery, especially when limited to video-assisted thoracoscopic surgery (VATS). We investigated the efficacy of scheduled-IV-AcA administration in patients after undergoing VATS.

Methods

Ninety-nine patients who underwent VATS lobectomy or segmentectomy via an 8-cm access window and 1 camera port were retrospectively reviewed by categorizing them into groups either with scheduled-IV-AcA (Group AcA: n = 29) or without it (Group non-AcA: n = 70). Group AcA received 1 g of IV-AcA every 6 h from the end of the operation until the end of POD2. Postoperative pain was measured using a numeric rating scale (NRS) three times per day until discharge.

Results

NRS scores were significantly lower in Group AcA with motion (on POD1 to the first point of POD2) than in Group non-AcA. Group non-AcA was also more likely to use additional analgesics than Group AcA (39% vs. 17%, p = 0.058).

Conclusions

Scheduled-IV-AcA administration is a safe and effective multimodal analgesic approach in patients undergoing VATS pulmonary resection via an 8-cm access window.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Garimella V, Cellini C. Postoperative pain control. Clin Colon Rectal Surg. 2013;26(3):191–6.

    Article  Google Scholar 

  2. Grosser T, Theken KN, FitzGerald GA, Inhibition C. Pain, inflammation, and the cardiovascular system. Clin Pharmacol Ther. 2017;102(4):611–22.

    Article  Google Scholar 

  3. Bollinger AJ, Butler PD, Nies MS, Sietsema DL, Jones CB, Endres TJ. Is scheduled intravenous acetaminophen effective in the pain management protocol of geriatric hip fractures? Geriatr Orthop Surg Rehab. 2015;6(3):202–8.

    Article  Google Scholar 

  4. Loop T, Harris S, Grimm A. Recent advances in postoperative pain therapy for thoracic surgery. Curr Anesthesiol Rep. 2014;4(2):177–87.

    Article  Google Scholar 

  5. Macario A, Royal MA. A literature review of randomized clinical trials of intravenous acetaminophen (paracetamol) for acute postoperative pain. Pain Pract Off J World Inst Pain. 2011;11(3):290–6.

    Article  Google Scholar 

  6. McNicol ED, Tzortzopoulou A, Cepeda MS, Francia MBD, Farhat T, Schumann R. Single-dose intravenous paracetamol or proparacetamol for prevention or treatment of postoperative pain: a systematic review and meta-analysis. Br J Anaesth. 2011;106(6):764–75.

    Article  CAS  Google Scholar 

  7. White PF. Multimodal analgesia: its role in preventing postoperative pain. Curr Opin Invest Drugs (Lond Engl 2000). 2008;9(1):76–82.

    CAS  Google Scholar 

  8. Song K, Melroy Michael J, Whipple Oliver C. Optimizing multimodal analgesia with intravenous acetaminophen and opioids in postoperative bariatric patients. Pharmacotherapy. J Human Pharmacol Drug Therap. 2014;34(S1):14S–21S1S.

    Article  CAS  Google Scholar 

  9. Mattia C, Coluzzi F. What anesthesiologists should know about paracetamol (acetaminophen). Minerva Anestesiol. 2009;75(11):644–53.

    CAS  PubMed  Google Scholar 

  10. Tiippana E, Nilsson E, Kalso E. Post-thoracotomy pain after thoracic epidural analgesia: a prospective follow-up study. Acta Anaesthesiol Scand. 2003;47(4):433–8.

    Article  CAS  Google Scholar 

  11. Peng Z, Li H, Zhang C, Qian X, Feng Z, Zhu S. A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on qualify of life. PLoS ONE. 2014;9(2):e90014.

    Article  Google Scholar 

  12. Brunelli A, Socci L, Refai M, Salati M, Xiumé F, Sabbatini A. Quality of life before and after major lung resection for lung cancer: a prospective follow-up analysis. Ann Thorac Surg. 2007;84(2):410–6.

    Article  Google Scholar 

  13. Katz J, Jackson M, Kavanagh BP, Sandler AN. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain. 1996;12(1):50–5.

    Article  CAS  Google Scholar 

  14. Duggan ST, Scott LJ. Intravenous paracetamol (acetaminophen). Drugs. 2009;69(1):101–13.

    Article  CAS  Google Scholar 

  15. Yoon E, Babar A, Choudhary M, Kutner M, Pyrsopoulos N. Acetaminophen-induced hepatotoxicity a comprehensive update. J Clin Trans Hepatol. 2016;4(2):131–42.

    Google Scholar 

  16. Jahr JS, Lee VK. Intravenous acetaminophen. Anesthesiol Clin. 2010;28(4):619–45.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan

    Yoshinobu Shikatani, Junichi Soh, Kazuhiko Shien, Takeshi Kurosaki, Shinji Ohtani, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane, Takahiro Oto & Shinichi Toyooka

  2. Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan

    Arata Taniguchi & Hiroshi Morimatsu

Authors
  1. Yoshinobu Shikatani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Junichi Soh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuhiko Shien
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takeshi Kurosaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shinji Ohtani
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiromasa Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Arata Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mikio Okazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Seiichiro Sugimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Masaomi Yamane
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Takahiro Oto
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hiroshi Morimatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Shinichi Toyooka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Junichi Soh.

Ethics declarations

Conflict of interest

All authors have no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shikatani, Y., Soh, J., Shien, K. et al. Effectiveness of scheduled intravenous acetaminophen in the postoperative pain management of video-assisted thoracic surgery. Surg Today 51, 589–594 (2021). https://doi.org/10.1007/s00595-020-02127-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-020-02127-y

Keywords

Search

Navigation