RESUMO
BACKGROUND: Acetaminophen is available in a variety of modalities but there is conflicting evidence as to whether intravenous provides superior analgesia than oral formulations METHODS: A prospective, randomized, triple-blinded clinical trial was conducted in which 100 participants, scheduled for any laparoscopic unilateral hernia repair surgery in the ambulatory setting, were computer randomized to receive either 975â¯mg oral acetaminophen or 1000â¯mg of intravenous acetaminophen. The primary outcomes evaluated were post-anesthesia care unit (PACU) pain scores at arrival, 1â¯hour discharge, 6â¯hour post-op as well as total opioid use intraoperatively and in PACU. Secondary outcomes were PACU length of stay, patient reported total opioid use in the first 24â¯h, pain scores 24â¯hour post-op and patient satisfaction. RESULTS: We found that no significant difference was appreciated between the oral and intravenous acetaminophen groups in any of the primary or secondary outcomes with the p-value of the pain score on arrival of 0.173, pain score at 1â¯h 0.544, pain score on discharge from PACU 0.586, pain score at 6â¯h 0.234, pain score at 24â¯h 0.133, total morphine milligram equivalents (MME) intraoperatively 0.096, total MME in PACU 0.960, time in PACU 0.15, home opioid MME 0.336, and overall patient satisfaction 0.067. CONCLUSIONS: We concluded that in the ambulatory surgery population the efficacy of oral and intravenous acetaminophen is equivalent.
