Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis

Background and Objectives: Preventive analgesia has been proposed as a potential strategy to reduce postoperative pain. However, there is currently no review that focuses on acetaminophen for preventive analgesia. Methods: We conducted a search of MEDLINE, EMBASE, Cinahl, AMED, and CENTRAL databa...

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Main Authors: Doleman, Brett, Read, David, Lund, Jonathan N., Williams, John P.
Format: Article
Published: Lippincott Williams & Wilkins 2015
Online Access:https://eprints.nottingham.ac.uk/40254/
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author Doleman, Brett
Read, David
Lund, Jonathan N.
Williams, John P.
author_facet Doleman, Brett
Read, David
Lund, Jonathan N.
Williams, John P.
author_sort Doleman, Brett
building Nottingham Research Data Repository
collection Online Access
description Background and Objectives: Preventive analgesia has been proposed as a potential strategy to reduce postoperative pain. However, there is currently no review that focuses on acetaminophen for preventive analgesia. Methods: We conducted a search of MEDLINE, EMBASE, Cinahl, AMED, and CENTRAL databases identifying randomized controlled trials that compared preventive acetaminophen with postincision acetaminophen. Results: Seven studies with 544 participants were included. Overall, the studies showed a reduction in 24-hour opioid consumption (standardized mean difference [SMD] of -0.52; 95% confidence interval [95% CI], -0.98 to -0.06), lower pain scores at 1 hour (MD, -0.50; 95% CI, -0.98 to -0.02) and 2 hours (MD, -0.34; 95% CI, -0.67 to -0.01), and a lower incidence of postoperative vomiting (risk ratio, 0.50; 95% CI, 0.31-0.83) in the preventive acetaminophen group. Current studies are limited by a potential risk of bias. Conclusions: To our knowledge, this is the first review to describe a potential preventive effect of acetaminophen. However, well-conducted randomized controlled trials are necessary to substantiate the conclusions of this review.
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spelling nottingham-402542020-05-04T17:18:00Z https://eprints.nottingham.ac.uk/40254/ Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis Doleman, Brett Read, David Lund, Jonathan N. Williams, John P. Background and Objectives: Preventive analgesia has been proposed as a potential strategy to reduce postoperative pain. However, there is currently no review that focuses on acetaminophen for preventive analgesia. Methods: We conducted a search of MEDLINE, EMBASE, Cinahl, AMED, and CENTRAL databases identifying randomized controlled trials that compared preventive acetaminophen with postincision acetaminophen. Results: Seven studies with 544 participants were included. Overall, the studies showed a reduction in 24-hour opioid consumption (standardized mean difference [SMD] of -0.52; 95% confidence interval [95% CI], -0.98 to -0.06), lower pain scores at 1 hour (MD, -0.50; 95% CI, -0.98 to -0.02) and 2 hours (MD, -0.34; 95% CI, -0.67 to -0.01), and a lower incidence of postoperative vomiting (risk ratio, 0.50; 95% CI, 0.31-0.83) in the preventive acetaminophen group. Current studies are limited by a potential risk of bias. Conclusions: To our knowledge, this is the first review to describe a potential preventive effect of acetaminophen. However, well-conducted randomized controlled trials are necessary to substantiate the conclusions of this review. Lippincott Williams & Wilkins 2015-11-01 Article PeerReviewed Doleman, Brett, Read, David, Lund, Jonathan N. and Williams, John P. (2015) Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis. Regional Anesthesia and Pain Medicine, 40 (6). pp. 706-712. ISSN 1532-8651 http://journals.lww.com/rapm/pages/articleviewer.aspx?year=2015&issue=11000&article=00008&type=abstract doi:10.1097/AAP.0000000000000311 doi:10.1097/AAP.0000000000000311
spellingShingle Doleman, Brett
Read, David
Lund, Jonathan N.
Williams, John P.
Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis
title Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis
title_full Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis
title_fullStr Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis
title_full_unstemmed Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis
title_short Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis
title_sort preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta-analysis
url https://eprints.nottingham.ac.uk/40254/
https://eprints.nottingham.ac.uk/40254/
https://eprints.nottingham.ac.uk/40254/