Decreased opioid consumption and enhance recovery with the addition of IV Acetaminophen in colorectal patients: a prospective, multi-institutional, randomized, double-blinded, placebo-controlled study (DOCIVA study)

Abstract

IV acetaminophen helps to reduce opioid consumption for patients undergoing colorectal surgery. Additionally, there appears to be a shortened length of hospital stay, better pain control, reduced time to return of bowel function, and lower rate of post-operative ileus in patients receiving IV acetaminophen.

The Enhanced Recovery After Surgery (ERAS) Elements that Most Greatly Impact Length of Stay and Readmission

“…It is appreciated that some individual elements such as the use of multimodal pain management strategies and limiting opioid use are independently associated with LOS. 11,12 Herein, we perform a retrospective review of 840 patients who underwent colorectal surgery in a community hospital setting to identify which specific subset of ERAS elements have the most impact on LOS and readmission using 2 independent statistical methods.…”

Multicentre, prospective, double-blind, randomised controlled clinical trial comparing different non-opioid analgesic combinations with morphine for postoperative analgesia: the OCTOPUS study

“…Unfortunately, studies comparing one weak NOA (paracetamol) and morphine have still been recently published. 15 We did not observe any benefit in terms of morphinerelated side-effects. Given the large differences in morphine consumptions, one can hypothesise that enhanced power might not alter them.…”

“…They allow a 30% reduction of morphine consumption and a reduction of PONV. 6 RCTs are scarce on bi-therapies, but 7169 (10) 171 (9) 172 (9) Body weight (kg) 75 (15) 74 (17) 71 (14) 73 (13) 69 (13) 76 (17) 80 (16) 75 (14) 80 17 e102 -Beloeil et al…”

Enhanced recovery for elective colorectal surgery: from safety bundles to package deals

“…Moreover, the concept of multimodal analgesia has been adopted on the basis of the synergistic effect of its components such as intravenous acetaminophen, nonsteroidal anti‐inflammatory drugs and transversus abdominis plane (TAP) block with the goal of restricting doses and side effects of opioids . In fact, the DOCIVA random order design study concluded that intravenous acetaminophen resulted in decreased opioid consumption . Nonetheless, a recent meta‐analysis showed that TAP blocks only decreased pain after laparoscopic colorectal surgery when patients were ambulant as opposed to at rest .…”