Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial
Abstract Background Multimodal perioperative analgesia including acetaminophen is recommended by current guidelines. The comparative efficacy of intravenous vs oral acetaminophen in sinus surgery is unknown. We aimed to determine whether intravenous or oral acetaminophen results in superior postoper...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.375 |
| _version_ | 1818480505269518336 |
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| author | Ravi Bhoja Matthew W. Ryan Kevin Klein Abu Minhajuddin Emily Melikman Mohamed Hamza Bradley F. Marple David L. McDonagh |
| author_facet | Ravi Bhoja Matthew W. Ryan Kevin Klein Abu Minhajuddin Emily Melikman Mohamed Hamza Bradley F. Marple David L. McDonagh |
| author_sort | Ravi Bhoja |
| collection | DOAJ |
| description | Abstract Background Multimodal perioperative analgesia including acetaminophen is recommended by current guidelines. The comparative efficacy of intravenous vs oral acetaminophen in sinus surgery is unknown. We aimed to determine whether intravenous or oral acetaminophen results in superior postoperative analgesia following sinus surgery. Methods This was a prospective randomized trial with blinded endpoint assessments conducted at a single large academic medical center. Subjects undergoing functional endoscopic sinus surgery were randomized to intravenous vs oral acetaminophen in addition to standard anesthetic and surgical care. The primary outcome was visual analogue scale pain score at 1 hour postoperatively. Results One hundred and ten adult patients were randomized; 9 were excluded from the data analysis. Fifty patients were assigned to intravenous acetaminophen and 51 to oral acetaminophen. Postoperative pain scores at 1 hour (primary endpoint) were not significantly different between the intravenous and oral acetaminophen groups. Similarly, there was no significant difference in pain scores at 24 hours postoperatively. Finally, there was no significant difference in postoperative opioid usage in the postanesthesia care unit or over the first 24 hours postoperatively. Conclusions This is the first comparative efficacy trial of oral vs intravenous acetaminophen in sinus surgery. There was no significant difference in pain scores at 1 or 24 hours postoperatively, and no difference in postoperative opioid use. Intravenous acetaminophen offers no apparent advantage over oral acetaminophen in patients undergoing sinus surgery. Level of Evidence 1b |
| first_indexed | 2024-12-10T11:24:34Z |
| format | Article |
| id | doaj.art-22f6299587f24a2384cde0d4595c2423 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-10T11:24:34Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-22f6299587f24a2384cde0d4595c24232022-12-22T01:50:47ZengWileyLaryngoscope Investigative Otolaryngology2378-80382020-06-015334835310.1002/lio2.375Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trialRavi Bhoja0Matthew W. Ryan1Kevin Klein2Abu Minhajuddin3Emily Melikman4Mohamed Hamza5Bradley F. Marple6David L. McDonagh7Department of Anesthesiology and Pain Management The University of Texas Southwestern Dallas Texas USADepartment of Otolaryngology The University of Texas Southwestern Dallas Texas USADepartment of Anesthesiology and Pain Management The University of Texas Southwestern Dallas Texas USADepartment of Anesthesiology and Pain Management The University of Texas Southwestern Dallas Texas USADepartment of Anesthesiology and Pain Management The University of Texas Southwestern Dallas Texas USADepartment of Anesthesiology and Pain Management The University of Texas Southwestern Dallas Texas USADepartment of Otolaryngology The University of Texas Southwestern Dallas Texas USADepartment of Anesthesiology and Pain Management The University of Texas Southwestern Dallas Texas USAAbstract Background Multimodal perioperative analgesia including acetaminophen is recommended by current guidelines. The comparative efficacy of intravenous vs oral acetaminophen in sinus surgery is unknown. We aimed to determine whether intravenous or oral acetaminophen results in superior postoperative analgesia following sinus surgery. Methods This was a prospective randomized trial with blinded endpoint assessments conducted at a single large academic medical center. Subjects undergoing functional endoscopic sinus surgery were randomized to intravenous vs oral acetaminophen in addition to standard anesthetic and surgical care. The primary outcome was visual analogue scale pain score at 1 hour postoperatively. Results One hundred and ten adult patients were randomized; 9 were excluded from the data analysis. Fifty patients were assigned to intravenous acetaminophen and 51 to oral acetaminophen. Postoperative pain scores at 1 hour (primary endpoint) were not significantly different between the intravenous and oral acetaminophen groups. Similarly, there was no significant difference in pain scores at 24 hours postoperatively. Finally, there was no significant difference in postoperative opioid usage in the postanesthesia care unit or over the first 24 hours postoperatively. Conclusions This is the first comparative efficacy trial of oral vs intravenous acetaminophen in sinus surgery. There was no significant difference in pain scores at 1 or 24 hours postoperatively, and no difference in postoperative opioid use. Intravenous acetaminophen offers no apparent advantage over oral acetaminophen in patients undergoing sinus surgery. Level of Evidence 1bhttps://doi.org/10.1002/lio2.375acetaminophenanalgesiafunctional endoscopic sinus surgeryintravenousoralpostoperative pain |
| spellingShingle | Ravi Bhoja Matthew W. Ryan Kevin Klein Abu Minhajuddin Emily Melikman Mohamed Hamza Bradley F. Marple David L. McDonagh Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial Laryngoscope Investigative Otolaryngology acetaminophen analgesia functional endoscopic sinus surgery intravenous oral postoperative pain |
| title | Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial |
| title_full | Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial |
| title_fullStr | Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial |
| title_full_unstemmed | Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial |
| title_short | Intravenous vs oral acetaminophen in sinus surgery: A randomized clinical trial |
| title_sort | intravenous vs oral acetaminophen in sinus surgery a randomized clinical trial |
| topic | acetaminophen analgesia functional endoscopic sinus surgery intravenous oral postoperative pain |
| url | https://doi.org/10.1002/lio2.375 |
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