Effectiveness of scheduled intravenous acetaminophen in the postoperative pain management of video-assisted thoracic sur
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ORIGINAL ARTICLE
Effectiveness of scheduled intravenous acetaminophen in the postoperative pain management of video‑assisted thoracic surgery Yoshinobu Shikatani1 · Junichi Soh1 · Kazuhiko Shien1 · Takeshi Kurosaki1 · Shinji Ohtani1 · Hiromasa Yamamoto1 · Arata Taniguchi2 · Mikio Okazaki1 · Seiichiro Sugimoto1 · Masaomi Yamane1 · Takahiro Oto1 · Hiroshi Morimatsu2 · Shinichi Toyooka1 Received: 10 May 2020 / Accepted: 13 August 2020 © Springer Nature Singapore Pte Ltd. 2020
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. Keywords Intravenous acetaminophen · Multimodal analgesia · Postoperative pain
Introduction Pain control is an important factor in recovery during the early postoperative period. However, the management of postoperative pain can be challenging due to inhibitors of cyclooxygenases, nonsteroidal anti-inflammatory drugs, and opioids, which cause a number of adverse side effects, such as gastrointestinal and cardiovascular complications [1–3].Severe postoperative pain, in general, impairs the * Junichi Soh [email protected] 1
Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama 700‑8558, Japan
Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan
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reinstatement of mobilization, increases perioperative morbidity, and has the potential to trigger a chronic pain syndrome with an incidence, dependent on the analgesic regimen, ranging from 21 to 61% [4]. The multimodal analgesic approach has recently been recommended as a reasonable postoperative pain management strategy [5, 6]. Multimodal analgesia is an
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