title: Impact of Postoperative Intravenous Acetaminophen on Opioid Requirements and Pain Scores Following Gynecologic Procedures.
abstract: OBJECTIVE
  This study aims to assess the impact of postoperative intravenous (IV) acetaminophen on opioid requirements and pain scores in patients following gynecologic procedures.
  
  
  METHODS
  A retrospective cohort study of patients undergoing gynecologic procedures was conducted to assess the impact of adding scheduled IV acetaminophen to postoperative analgesic regimens. The control group consisted of patients admitted prior to formulary addition of IV acetaminophen; the study group consisted of patients admitted after formulary addition of IV acetaminophen who received scheduled IV acetaminophen for at least the first 24 hours postoperatively. Opioid requirements 0 to 24 hours postoperatively served as the primary end point. Secondary end points included average pain score, cumulative acetaminophen dose, nonopioid analgesic requirements, and rate of adverse events 0 to 24 hours postoperatively.
  
  
  RESULTS
  One hundred and thirty-seven patients who underwent a gynecologic procedure from January 2009 to April 2013 were included in this study. Baseline characteristics were similar between the groups. In the first 24 hours postoperatively, there was no difference in opioid requirements between the groups (21 mg [interquartile range, IQR, 15-39.8 mg] vs 32.6 mg [IQR, 16.75-41 mg], P = 0.150). The average pain score and incidence of adverse events did not differ between the 2 groups.
  
  
  CONCLUSIONS
  Postoperative administration of IV acetaminophen did not provide a significant opioid-sparing effect in patients undergoing gynecologic procedures.
authors: Department of Pharmacy, Saint Thomas West Hospital, Nashville, TN, USA Laura.Stoudenmire@sth.org.
authors: Laura G
authors: LG
authors: Stoudenmire
authors: Department of Pharmacy, Georgia Regents Health System, Augusta, GA, USA.
authors: Christy M
authors: CM
authors: Norman
authors: Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, GA, USA.
authors: Erin Z
authors: EZ
authors: Latif
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061605:Administration, Intravenous; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D016022:Case-Control Studies; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006801:Humans; D010147:Pain Measurement / Q000187:drug effects*; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen
keywords: gynecological; intravenous acetaminophen; opioid requirements; postoperative