Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis

Doleman, Brett; Read, David; Lund, Jonathan N.; Williams, John P.

Abstract

Background and Objectives: Preventive analgesia has been proposed as a potential strategy to reduce postoperative pain. However, there is currently no review that focuses on acetaminophen for preventive analgesia.

Methods: We conducted a search of MEDLINE, EMBASE, Cinahl, AMED, and CENTRAL databases identifying randomized controlled trials that compared preventive acetaminophen with postincision acetaminophen.

Results: Seven studies with 544 participants were included. Overall, the studies showed a reduction in 24-hour opioid consumption (standardized mean difference [SMD] of -0.52; 95% confidence interval [95% CI], -0.98 to -0.06), lower pain scores at 1 hour (MD, -0.50; 95% CI, -0.98 to -0.02) and 2 hours (MD, -0.34; 95% CI, -0.67 to -0.01), and a lower incidence of postoperative vomiting (risk ratio, 0.50; 95% CI, 0.31-0.83) in the preventive acetaminophen group. Current studies are limited by a potential risk of bias.

Conclusions: To our knowledge, this is the first review to describe a potential preventive effect of acetaminophen. However, well-conducted randomized controlled trials are necessary to substantiate the conclusions of this review.

Citation

Doleman, B., Read, D., Lund, J. N., & Williams, J. P. (2015). Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis. Regional Anesthesia and Pain Medicine, 40(6), https://doi.org/10.1097/AAP.0000000000000311

• Journal Article Type: Article
• Acceptance Date: Jul 9, 2015
• Publication Date: Nov 1, 2015
• Deposit Date: Feb 2, 2017
• Publicly Available Date: Feb 2, 2017
• Journal: Regional Anesthesia and Pain Medicine
• Print ISSN: 1098-7339
• Electronic ISSN: 1532-8651
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 40
• Issue: 6
• DOI: https://doi.org/10.1097/AAP.0000000000000311
• Public URL: https://nottingham-repository.worktribe.com/output/762332
• Publisher URL: http://journals.lww.com/rapm/pages/articleviewer.aspx?year=2015&issue=11000&article=00008&type=abstract
• Contract Date: Feb 2, 2017