Abstract:
PURPOSES:To investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance the recovery after esophagectomy. METHODS: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. RESULTS: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. CONCLUSIONS: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.
journal_name
Surg Todayjournal_title
Surgery todayauthors
Ohkura Y,Shindoh J,Ueno M,Iizuka T,Haruta S,Udagawa Hdoi
10.1007/s00595-017-1616-5subject
Has Abstractpub_date
2018-05-01 00:00:00pages
502-509issue
5eissn
0941-1291issn
1436-2813pii
10.1007/s00595-017-1616-5journal_volume
48pub_type
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