The efficiency of intravenous acetaminophen for pain control following total knee and hip arthroplasty

Abstract

Background:This meta-analysis aimed to evaluate the efficiency and safety of intravenous acetaminophen as an adjunct to multimodal analgesia for pain control after total joint arthroplasty (TJA).Methods:PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) and non-RCTs were included. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Meta-analysis was performed using Stata 11.0 software.Results:Four studies including 865 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of pain scores at 24 hours (weighted mean difference [WMD] = −0.926, 95% confidence interval [CI]: −1.171 to −0.681, P = .000), 48 hours (WMD = −0.905, 95% CI: −1.198 to −0.612, P = .000), and 72 hours (WMD = −0.279, 95% CI: −0.538 to −0.021, P = .034). Significant differences were found regarding opioid consumption at 24 hours (WMD = −4.043, 95% CI: −5.041 to −3.046, P = .000), 48 hours (WMD = −5.665, 95% CI: −7.383 to −3.947, P = .000), and 72 hours (WMD = −6.338, 95% CI: −7.477 to −5.199, P = .000).Conclusion:Intravenous acetaminophen was efficacious for reducing postoperative pain and opioid consumption than the placebo following total joint arthroplasty. Due to the limited quality of the evidence currently available, more RCTs are needed.

Curcumin reduces inflammation in knee osteoarthritis rats through blocking TLR4 /MyD88/NF‐κB signal pathway

“…Patients and their physicians often turn to surgical treatments to address progressive pain and disability, including arthroscopy and total knee arthroplasty (TKA) (Bonanzinga et al, 2018;Ro, Heo, & Lee, 2018). However, in 6 months after TKA, 16-39% of patients still sustain knee pain (Liang, Cai, Li, & Ma, 2017).…”

Evolution of an Opioid Sparse Pain Management Program for Total Knee Arthroplasty With the Addition of Intravenous Acetaminophen

“…One randomized, doubleblinded trial showed that patients receiving IV acetaminophen following TKA had better pain relief [11]. In another prospective study, Gupta et al [21] showed that IV acetaminophen significantly reduced patients' pain scores, a finding confirmed by multiple other authors [10,13]. In particular, administering IV acetaminophen intraoperatively may reduce pain in the immediate postoperative period [22].…”

“…Recent studies of TJA patients receiving IV acetaminophen have demonstrated a reduced LOS, fewer adverse events [9], lower pain scores [10,11] and opioid requirements [11], and a decreased need for rescue opioids [12]. However, 2 recent meta-analyses have shown mixed results, citing limited quality evidence supporting the use of IV acetaminophen and the need for future randomized controlled trials [13,14]. In contrast, 2 recent prospective trials found modest improvements in pain and opioid consumption [18,20].…”

“…Recent studies within the total joint arthroplasty patient population have demonstrated that IV acetaminophen has helped reduce patient LOS and opioid-related adverse events [9], decreases patients' reported pain scores [10,11] and overall opioid requirements [10], and decreases the need for rescue opioids [12]. However, 2 recent meta-analyses have demonstrated mixed results [13,14].…”

Multimodal analgesia with anapiron, nonsteriod anti-inflammatory drugs, local infiltrative anesthesia, and pregabalin in case of primary total hip arthroplasty

“…Матааналіз, проведений L. Liang та співавт. [17] показав, що внутрішньовенне введення парацетамолу значно знизило післяопераційні показники болю та зменшило використання опіоїдів після ендопротезування кульшового та колінного суглобів. За інформацією, поданою в спеціальній літературі, використання парекоксибу зменшує споживання морфіну приблизно на 30 % у перші 24 год після різних видів операцій [18,19].…”