Intravenous Acetaminophen for Postoperative Pain Management in Patients Undergoing Living Laparoscopic Living-Donor Nephrectomy.
BACKGROUND
Postoperative pain is a common complication of laparoscopic living-donor nephrectomies (LLDNs).


OBJECTIVE
To determine whether intravenous (IV) acetaminophen administration post-LLDN influenced length of stay (LOS) when used for pain management.


METHODS
This single-center, retrospective study compared patients undergoing LLDN who had received IV acetaminophen for pain control versus those who did not between June 1, 2011, and November 30, 2015. Patient LOS, 30-day readmissions, frequency of pain assessments, patient-reported pain scores, and opioid administration were assessed.


RESULTS
A total of 90 patients were included in the analysis (IV acetaminophen, n = 48; non-IV acetaminophen, n = 42). Patients who did not receive IV acetaminophen were more often older (48.8 ± 12.1 vs 39.3 ± 12.1 years; P = 0.012) and female (71.4% vs 47.9%; P < 0.001). The average LOS was similar between the 2 groups (median = 3.0; interquartile range = [3, 4] vs 3.5 [3, 4]; P = 0.737). The 30-day readmissions were higher in the IV acetaminophen group (16.7%) compared with the group not receiving IV acetaminophen (2.4%; P = 0.033). After the first postoperative day, the frequencies of pain assessments performed were similar among the 2 groups. There was no difference in average pain scores between the groups at any time after LLDN.


CONCLUSIONS
Patients receiving IV acetaminophen were found to have no improvements in hospital LOS, average pain score, or opioid requirements compared with patients not receiving IV acetaminophen. Patients who received IV acetaminophen were also found to have a higher 30-day readmission rate.
1 University of Saint Joseph School of Pharmacy, West Hartford, CT, USA.|2 Hartford Hospital, Hartford, CT, USA.
Van
V
Vu
3 University of Connecticut School of Pharmacy, Storrs, CT, USA.
William L
WL
Baker
3 University of Connecticut School of Pharmacy, Storrs, CT, USA.|4 University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Elizabeth M
EM
Tencza
2 Hartford Hospital, Hartford, CT, USA.
Caroline
C
Rochon
2 Hartford Hospital, Hartford, CT, USA.
Patricia A
PA
Sheiner
2 Hartford Hospital, Hartford, CT, USA.
Spencer T
ST
Martin
D000082:Acetaminophen / Q000008:administration & dosage* / Q000627:therapeutic use; D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D016030:Kidney Transplantation; D010535:Laparoscopy; D007902:Length of Stay; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000451:nursing; D010149:Postoperative Pain / Q000188:drug therapy*; D010359:Patient Readmission; D012189:Retrospective Studies
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen
acetaminophen; nephrology; pain management; surgery; transplantation