Intravenous Acetaminophen -an Ineffective Analgesic?

摘要

Wang et al. reported in the December 2015 issue of P&T that patients after bariatric surgery administered intravenous (IV) acetaminophen required higher doses of opioids in the postoperative period than patients on opioids alone. We would like to comment on two points necessitating a discussion.First, the findings of the presented, small, retrospective study (N = 96) are in conflict with several large meta-analyses, including many prospective randomized trials with thousands of patients. Possible explanations could include: 1) different bariatric surgical procedures; 2) unchanged opioid prescribing practices after IV acetaminophen was added to the hospital's formulary; and 3) noncompliance to American Society of Anesthesiologists practice guidelines to schedule acetaminophen and nonsteroidal anti-inflammatory drugs around the clock unless contraindicated.