Scheduled intravenous acetaminophen versus nonsteroidal anti-inflammatory drugs (NSAIDs) for better short-term outcomes
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ORIGINAL ARTICLE
Scheduled intravenous acetaminophen versus nonsteroidal anti‑inflammatory drugs (NSAIDs) for better short‑term outcomes after esophagectomy for esophageal cancer Jiro Kawakami1,2 · Tetsuya Abe1 · Eiji Higaki1 · Takahiro Hosoi1 · Masahide Fukaya2 · Koji Komori1 · Seiji Ito1 · Masahiro Nakatochi3,4 · Masato Nagino2 · Yasuhiro Shimizu1 Received: 17 July 2019 / Accepted: 6 March 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose To evaluate the effect of scheduled intravenous acetaminophen administration versus nonsteroidal anti-inflammatory drugs on postoperative pain and short-term outcomes after esophagectomy. Methods The subjects of this study were 150 consecutive patients who underwent esophagectomy for esophageal cancer. Seventy-seven patients received scheduled intravenous acetaminophen and the other 73 received NSAIDs enterally for postoperative pain management. We compared the postoperative pain and short-term outcomes between the groups. Inverse probability of treatment weighting (IPTW) based on propensity scores was used to control for selection bias. Results The visual analog scale (VAS) of postoperative pain was lower in the acetaminophen group than in the NSAIDs group, based on the mean values of chest VAS on postoperative days (PODs) 0, 4, 5, and 6 and the mean values of abdomen VAS on PODs 4, 5, and 6. The incidence of anastomotic leakage and postoperative delirium was lower in the acetaminophen group than in the NSAIDs group (anastomotic leakage, odds ratio (OR) 0.3, p = 0.01; postoperative delirium, OR 0.19, p
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