BackgroundClinical cases are often observed when patients are in need of repeated use of analgesic infusion to manage pain after colon cancer surgery. This paper investigates analgesic frequency as well as safety of postoperative intravenous (IV) acetaminophen in colon cancer surgery where epidural anesthesia is used.MethodsAmong patients who received epidural anesthesia during colon cancer surgery, one group of twenty eight (28) patients received acetaminophen while another group of patients (30) did not receive it. The groups were analyzed from the surgery day to two days after for the postoperative occurrence and frequency of liver dysfunction in relation to analgesic usage.ResultsThe patient group with acetaminophen infusion significantly reduced the amount of analgesic medication compared to the group without the treatment (p = 0.008). Furthermore there was a significantly larger number of patients in the group receiving acetaminophen treatment with the baseline increase of alanine aminotransferase (p = 0.043). In most of the cases, however, the rate of the increase is mild and the patients did not need medication and subsequently recovered quickly.ConclusionsScheduled IV infusion of acetaminophen after colon cancer surgey is concluded an effective method of pain control and alleviation of postoperative discomfort from the surgery day to two days after the surgery.
When hospitalized patients develop infections, it extends their hospital stay and can increase their risk of death. Preventing the onset of infection reduces the burden on patients as well as on the hospital. Controlling the amount of antibiotics used can also help to suppress drug-resistant bacteria. When the flow rate of long chain triglyceride lipid emulsion in nutritional supplementation is fast, it has been reported that it could inhibit reticuloendothelial function because artificial triglycerides accumulate in the blood. However, accumulation of artificial triglycerides can be avoided when the flow rate is less than 0.10 g/kg/hr. We examined the relationship between the presence/lack of infections and the flow rate of lipid emulsion, by studying 23 patients with body weights under 40 kg who were administered lipid emulsion intravenously for a period of 14 days or more. Of the infected group, 5 out of 13 cases (38.5%) received a flow rate less than 0.10 g/kg/hr. However, in the non-infected group, 8 out of 10 cases (80.0%) had been administered a flow rate that was less than 0.10 g/kg/hr (P = 0.046). Therefore, we believe the risk of infection can be suppressed by managing the intravenous lipid emulsion flow rate at less than 0.10 g/kg/hr.
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