title: Intravenous acetaminophen in bariatric surgery: effects on opioid requirements.
abstract: BACKGROUND
  Opioids are commonly used after bariatric surgery for pain control because of their potent analgesic effects. Nevertheless, the morbidly obese patient has increased risk for developing adverse effects produced by opioids (such as sedation, apnea, hypoxemia, ileus, and vomiting). Intravenous acetaminophen (IVA) has been evaluated in some specialties showing a reduction in opioid consumption. The purpose of this study was to evaluate the effect on opioid consumption when IVA is administered in bariatric surgery patients.
  
  
  METHODS
  A retrospective study was performed in patients who underwent bariatric surgery. Group A included those patients who received IVA perioperatively and group B those who did not. The amount of opioids administered was calculated and compared for each group.
  
  
  RESULTS
  Group A included 38 cases (44.7%) and group B included 47 cases (55.3%). A comparison was performed in terms of age (P = 0.349), body mass index (P = 0.311), gender (P = 0.890), American Society of Anesthesiologist score (P = 0.438), total surgical time (P = 0.497), perioperative complications (P = 0.786), number of procedures per surgeon (P = 0.08), and type of surgical procedure (P ≤ 0.01). Group A had a mean 24-h total opioid dose of 99.5 mg, whereas group B of 164.6 mg (P = 0.018). Group A received 39.5% less opioids than group B. A post hoc analysis determined a statistical power of 0.74.
  
  
  CONCLUSIONS
  IVA used perioperatively can decrease opioid consumption in patients after bariatric surgery. Randomized trials are needed to corroborate these results.
authors: Department of General and Bariatric Surgery, Baptist Health South Florida, Miami, Florida. Electronic address: reyr@obesityhealth.com.mx.
authors: Anthony Michael
authors: AM
authors: Gonzalez
authors: Department of General and Bariatric Surgery, Baptist Health South Florida, Miami, Florida.
authors: Rey Jesús
authors: RJ
authors: Romero
authors: Nursing & Allied Health Sciences Research, Baptist Health South Florida, Miami, Florida.
authors: Maria M
authors: MM
authors: Ojeda-Vaz
authors: Department of General and Bariatric Surgery, Baptist Health South Florida, Miami, Florida.
authors: Jorge Rafael
authors: JR
authors: Rabaza
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D050110:Bariatric Surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen
keywords: Bariatric surgery; IV acetaminophen; Ofirmev; Opioids; Pain