title: Oral acetaminophen (paracetamol) for additional analgesia in phacoemulsification cataract surgery performed using topical anesthesia Randomized double-masked placebo-controlled trial.
abstract: OBJECTIVE
  To evaluate the clinical analgesic efficacy of 1.0 g oral acetaminophen (paracetamol) given in addition to topical anesthesia before phacoemulsification cataract surgery.
  
  
  METHODS
  Inpatient and outpatient ophthalmology clinics, Bydgoszcz, Poland.
  
  
  METHODS
  Consecutive patients with age-related cataract having phacoemulsification under topical anesthesia (tetracaine 0.5%) were enrolled in a prospective double-blind randomized placebo-controlled study. Patients were randomly assigned to preoperative oral administration of a placebo medication or to oral administration of 1.0 g acetaminophen. The main outcome measure was intensity of pain during and after surgery. Pain intensity was measured using a 10 cm baseline visual analog scale and a discrete 5-category verbal rating scale.
  
  
  RESULTS
  The study comprised 160 consecutive patients (80 in each group). Intraoperatively, the mean visual analog scale pain intensity score was 2.17 +/- 1.81 in the placebo group and 1.45 +/- 1.17 in the acetaminophen group and the mean verbal rating scale score, 1.11 +/- 0.73 and 0.67 +/- 0.66, respectively (P<.01). Postoperatively, the mean visual analog scale score for pain was 1.47 +/- 1.39 in the placebo group and 0.56 +/- 0.61 in the acetaminophen group and the mean verbal rating scale score, 0.94 +/- 0.79 and 0.28 +/- 0.41, respectively (P<.01). There was no significant difference in patient behavior during surgery and no significant adverse effects of acetaminophen use.
  
  
  CONCLUSIONS
  Preoperative oral administration of acetaminophen 1.0 g was effective, convenient, safe, and cost effective in reducing intraoperative and postoperative pain in phacoemulsification performed using topical anesthesia.
authors.affiliation: Department of Ophthalmology, Collegium Medicum, Nicolas Copernicus University, Oftalmika Eye Hospital, Curie-Sklodowskiej 9, 85-094 Bydgoszcz, Poland. bartka@by.onet.pl
authors.forename: Bartlomiej J
authors.initials: BJ
authors.lastname: Kaluzny
authors.forename: Karolina
authors.initials: K
authors.lastname: Kazmierczak
authors.forename: Adriana
authors.initials: A
authors.lastname: Laudencka
authors.forename: Iwona
authors.initials: I
authors.lastname: Eliks
authors.forename: Jakub J
authors.initials: JJ
authors.lastname: Kaluzny
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000191:economics; D000284:Administration, Oral; D000368:Aged; D000698:Analgesia / Q000379:methods; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000191:economics; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D004311:Double-Blind Method; D016527:Drug Costs; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D019654:Lens Implantation, Intraocular; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D018918:Phacoemulsification; D013748:Tetracaine / Q000008:administration & dosage; D014792:Visual Acuity
chemical_list: D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D013748:Tetracaine; D000082:Acetaminophen