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Intravenous acetaminophen

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https://www.readbyqxmd.com/read/29783269/adding-paracetamol-to-ibuprofen-for-the-treatment-of-patent-ductus-arteriosus-in-preterm-infants-a-double-blind-randomized-placebo-controlled-pilot-study
#1
Ori Hochwald, Gur Mainzer, Liron Borenstein-Levin, Huda Jubran, Gil Dinur, Meirav Zucker, Malka Mor, Asaad Khoury, Amir Kugelman
OBJECTIVE:  The objective of this study was to compare the closure rate of hemodynamically significant patent ductus arteriosus (hsPDA) of intravenous ibuprofen + paracetamol (acetaminophen) versus ibuprofen + placebo, in preterm infants of 24 to 316/7 weeks postmenstrual age. STUDY DESIGN:  This is a single-center, double-blind, randomized controlled pilot study. Infants were assigned for treatment with either intravenous ibuprofen + paracetamol ( n  = 12) or ibuprofen + placebo ( n  = 12)...
May 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29779020/acetaminophen-reduces-acute-and-persistent-incisional-pain-after-hysterectomy
#2
Onur Koyuncu, Sedat Hakimoglu, Mustafa Ugur, Cagla Akkurt, Selim Turhanoglu, Daniel Sessler, Alparslan Turan
OBJECTIVE: Acetaminophen is effective for acute surgical pain, but whether it reduces persistent incision pain remains unknown. We tested the primary hypothesis that patients given perioperative acetaminophen have less incisional pain three months after surgery. Our secondary hypotheses were that patients randomized to acetaminophen have less postoperative pain and analgesic consumption, and better functional recovery at three months. METHODS: 140 patients having abdominal hysterectomy were randomly assigned to: 1)intravenous acetaminophen (4 g/day for 72 postoperative hours); or, 2) saline placebo...
May 15, 2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29771804/preemptive-analgesia-decreases-pain-following-anorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#3
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29734456/intravenous-acetaminophen-may-be-associated-with-reduced-odds-of-30-day-readmission-after-total-knee-arthroplasty
#4
Michael A Mont, Belinda Lovelace, An T Pham, Ryan N Hansen, Morad Chughtai, Chukwuweike U Gwam, Anton Khlopas, John W Barrington
The purpose of this study was (1) to evaluate 30-day readmission rates in total knee arthroplasty (TKA) patients who either received intravenous (IV) or oral (PO) acetaminophen (APAP) perioperatively and (2) to extrapolate the potential annual cost savings on the national level. This was a review of 190,691 TKA recipients between the years 2012 and 2015 who received either IV ( n  = 56,475) or PO APAP ( n  = 134,216). All-cause readmissions that occurred between patient discharge and 30 days postdischarge were recorded...
May 7, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29733098/oxycodone-is-safe-and-effective-for-general-anesthesia
#5
Stefan Wirz, Richard K Ellerkmann, Martin Soehle, Christian-Dieter Wirtz
PURPOSE: In clinical practice, using different opioid analgesics is common during the induction and maintenance of general anesthesia and for postoperative analgesia. However, if the opioid analgesic could be limited to a single drug, we hypothesized that the risk of adverse drug interactions could be reduced, with fewer adverse effects. We examined the use of oxycodone as a single opioid in a well-defined cohort of orthopedic patients undergoing general anesthesia. METHODS: In this retrolective, monocentric investigation, we reviewed data from 83 patients who underwent general anesthesia and received intravenous oxycodone as the sole analgesic (0...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29723901/metoclopramide-and-diphenhydramine-a-randomized-controlled-trial-of-a-treatment-for-headache-in-pregnancy-when-acetaminophen-alone-is-ineffective-mad-headache-study
#6
Katherine M Scolari Childress, Christina Dothager, Jeffrey A Gavard, Sara Lebovitz, Catherine Laska, Dorothea J Mostello
OBJECTIVE:  We investigated whether metoclopramide administered with diphenhydramine (MAD) relieves headache in pregnant women when acetaminophen alone is ineffective, using codeine for comparison. STUDY DESIGN:  Normotensive pregnant women in the second or third trimester were randomized to MAD intravenously (10 mg and 25 mg, respectively) or codeine orally (30 mg) for headache after 650 to 1,000 mg of acetaminophen failed to relieve their headaches. Headache severity (pain score 0-10) was noted at intervals over 24 hours...
May 3, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29707092/improved-outcomes-associated-with-the-use-of-intravenous-acetaminophen-for-management-of-acute-post-surgical-pain-in-cesarean-sections-and-hysterectomies
#7
Richard D Urman, Elaine A Boing, An T Pham, Victor Khangulov, Randi Fain, Brian H Nathanson, Xuan Zhang, George J Wan, Belinda Lovelace, Jessica Cirillo
Background: Post-surgical pain impacts many patient outcomes. Effective pain management increasingly relies on multimodal analgesia regimens in which acetaminophen (APAP) is a key component. The aim of our study was to examine the impact of oral APAP versus intravenous (IV) APAP as a component of post-surgical pain management after Cesarean sections and hysterectomies. Methods: A retrospective analysis of the Cerner HealthFacts® database (from January, 2011 to December, 2015) was conducted to compare outcomes of Cesarean section and hysterectomy surgery patients who received oral APAP to those who received IV APAP post-surgically...
June 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29680280/pediatric-oral-formulation-of-dendrimer-n-acetyl-l-cysteine-conjugates-for-the-treatment-of-neuroinflammation
#8
Venkata K Yellepeddi, Raziye Mohammadpour, Siva P Kambhampati, Casey Sayre, Manoj K Mishra, Rangaramanujam M Kannan, Hamidreza Ghandehari
N-acetyl-L-cysteine (NAC) commonly used as an antidote in acetaminophen poisoning has shown promise in the treatment of neurological disorders such as cerebral palsy (CP). However, NAC suffers from drawbacks such as poor oral bioavailability and suboptimal blood-brain-barrier (BBB) permeability limiting its clinical success. It was previously demonstrated that intravenous administration of dendrimer-NAC (D-NAC) conjugates have shown significant promise in the targeted treatment of neuroinflammation, in multiple preclinical models...
April 19, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29678487/effective-postoperative-analgesia-using-intravenous-flurbiprofen-and-acetaminophen
#9
Mitsuhiro Yoshida, Yoshitaka Shimizu, Keita Yoshida, Akari Mukai, Mitsuru Doi, Masahiro Irifune
PURPOSE: Management of postoperative pain is one of the most important components in postoperative care, because most patients have pain after dental surgery. The aim of this study was to evaluate whether acetaminophen could be an alternative to fentanyl in combination with a nonsteroidal anti-inflammatory drug (NSAID) as an analgesic after dental surgery in cases in which narcotic drugs were contraindicated. MATERIALS AND METHODS: Patients were 24- to 54-year-old men who underwent enucleation of a mandibular cyst under general anesthesia...
March 28, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29677001/impact-of-intravenous-acetaminophen-on-perioperative-opioid-utilization-and-outcomes-in-open-colectomies-a-claims-database-analysis
#10
Isaac Wasserman, Jashvant Poeran, Nicole Zubizarreta, Jason Babby, Stelian Serban, Andrew T Goldberg, Alexander J Greenstein, Stavros G Memtsoudis, Madhu Mazumdar, Andrew B Leibowitz
BACKGROUND: The value of intravenous acetaminophen in postoperative pain management remains debated. The authors tested the hypothesis that intravenous acetaminophen use, in isolation and in comparison to oral, would be associated with decreased opioid utilization (clinically significant reduction defined as 25%) and opioid-related adverse effects in open colectomy patients. METHODS: Using national claims data from open colectomy patients (Premier Healthcare Database, Premier Healthcare Solutions, Inc...
April 20, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29676689/intravenous-acetaminophen-for-postoperative-supratentorial-craniotomy-pain-a-prospective-randomized-double-blinded-placebo-controlled-trial
#11
Walavan Sivakumar, Michael Jensen, Julie Martinez, Michael Tanana, Nancy Duncan, Robert Hoesch, Jay K Riva-Cambrin, Craig Kilburg, Safdar Ansari, Paul A House
OBJECTIVE Acute pain control after cranial surgery is challenging. Prior research has shown that patients experience inadequate pain control post-craniotomy. The use of oral medications is sometimes delayed because of postoperative nausea, and the use of narcotics can impair the evaluation of brain function and thus are used judiciously. Few nonnarcotic intravenous (IV) analgesics exist. The authors present the results of the first prospective study evaluating the use of IV acetaminophen in patients after elective craniotomy...
April 20, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29659631/the-hemodynamic-effects-of-intravenous-paracetamol-acetaminophen-vs-normal-saline-in-cardiac-surgery-patients-a-single-center-placebo-controlled-randomized-study
#12
Elizabeth Chiam, Rinaldo Bellomo, Leonid Churilov, Laurence Weinberg
The hemodynamic effects of intravenous (IV) paracetamol in patients undergoing cardiac surgery are unknown. We performed a prospective single center placebo controlled randomized study with parallel group design in adult patients undergoing elective cardiac surgery. Participants received paracetamol (1 gram) IV or placebo (an equal volume of 0.9% saline) preoperatively followed by two postoperative doses 6 hours apart. The primary endpoint was the absolute change in systolic (SBP) 30 minutes after the preoperative infusion, analysed using an ANCOVA model...
2018: PloS One
https://www.readbyqxmd.com/read/29628196/effectiveness-of-novel-adjuncts-in-pain-management-following-total-knee-arthroplasty-a-randomized-clinical-trial
#13
Juan C Suarez, Ahmed A Al-Mansoori, Sumit Kanwar, Jesus M Villa, Colin A McNamara, Preetesh D Patel
BACKGROUND: Total knee arthroplasty (TKA) can be associated with significant pain which can negatively impact outcomes. Multiple strategies have been employed to reduce pain. The aim of this study is to compare the effectiveness of 3 different pain management modalities after TKA that included (1) our standardized knee injection cocktail and oral acetaminophen, (2) liposomal bupivacaine periarticular injection and oral acetaminophen, and (3) our standardized knee injection cocktail and intravenous (IV) acetaminophen...
March 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29624206/paracetamol-acetaminophen-for-patent-ductus-arteriosus-in-preterm-or-low-birth-weight-infants
#14
REVIEW
Arne Ohlsson, Prakeshkumar S Shah
BACKGROUND: In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically; or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. An association between prenatal or postnatal exposure to paracetamol and later development of autism or autism spectrum disorder has been reported...
April 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29619627/new-advances-in-acute-postoperative-pain-management
#15
REVIEW
Sukanya Mitra, Daniel Carlyle, Gopal Kodumudi, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: Postoperative pain remains one of the most common challenges following inpatient and outpatient surgeries. With our advances in modern medicine, pain following surgical procedures still remains a challenge, though significant accomplishments have been made over the past few decades. This article highlights some of the promising new advances and approaches in postoperative pain management. RECENT FINDINGS: Over the last decade, Enhanced Recovery after Surgery (ERAS) pathways and protocols are becoming the benchmark standards for enhancing postoperative recovery...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29605073/non-intensive-care-unit-management-of-acute-liver-failure
#16
REVIEW
Andres F Carrion, Paul Martin
Acute liver failure (ALF) is an uncommon syndrome with a highly variable and unpredictable clinical course. The initial diagnostic evaluation is typically performed in a non-intensive care unit (ICU) setting, like the emergency department or general hospital ward. Prompt restoration of intravascular volume with intravenous fluids and correction of electrolyte, metabolic, and acid-base disturbances are important initial interventions in the management of ALF and can be safely accomplished in non-ICU settings in many patients...
May 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29596101/intravenous-acetaminophen-does-not-reduce-inpatient-opioid-prescription-or-opioid-related-adverse-events-among-patients-undergoing-spine-surgery
#17
Eva E Mörwald, Jashvant Poeran, Nicole Zubizarreta, Crispiana Cozowicz, Madhu Mazumdar, Stavros G Memtsoudis
BACKGROUND: Having entered the US market relatively recently, the perioperative role of intravenous acetaminophen (ivAPAP) remains to be established for several surgeries. Using national data, we therefore assessed current utilization and whether it reduces inpatient opioid prescription and opioid-related side effects in a procedure with relatively high opioid utilization. METHODS: Patients undergoing a lumbar/lumbosacral spinal fusion (n = 117,269; 2011-2014) were retrospectively identified in a nationwide database and categorized by the amount and timing of ivAPAP administration (1 or >1 dose on postoperative day [POD] 0, 1, or 1+)...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29584842/association-of-placebo-indomethacin-ibuprofen-and-acetaminophen-with-closure-of-hemodynamically-significant-patent-ductus-arteriosus-in-preterm-infants-a-systematic-review-and-meta-analysis
#18
REVIEW
Souvik Mitra, Ivan D Florez, Maria E Tamayo, Lawrence Mbuagbaw, Thuva Vanniyasingam, Areti Angeliki Veroniki, Adriana M Zea, Yuan Zhang, Behnam Sadeghirad, Lehana Thabane
Importance: Despite increasing emphasis on conservative management of patent ductus arteriosus (PDA) in preterm infants, different pharmacotherapeutic interventions are used to treat those developing a hemodynamically significant PDA. Objectives: To estimate the relative likelihood of hemodynamically significant PDA closure with common pharmacotherapeutic interventions and to compare adverse event rates. Data Sources and Study Selection: The databases of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until August 15, 2015, and updated on December 31, 2017, along with conference proceedings up to December 2017...
March 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29578803/opioid-sparing-in-cleft-palate-surgery
#19
Logan Carr, Megan Gray, Brad Morrow, Morgan Brgoch, Donald Mackay, Thomas Samson
OBJECTIVE: This study aimed to determine whether intraoperative acetaminophen was able to decrease opioid consumption, pain scores, and length of stay while increasing oral intake in cleft palate surgery. DESIGN/SETTING/PATIENTS: One hundred consecutive patients with cleft palate who underwent a von Langenbeck or 2-flap palatoplasty and intravelar veloplasty at a tertiary medical center by the 2 senior authors from 2010 to 2015 were reviewed. INTERVENTIONS: Three intraoperative treatment groups were analyzed: intravenous (IV) acetaminophen, per rectal (PR) acetaminophen, and no acetaminophen...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29569172/a-retrospective-evaluation-of-the-perioperative-drug-use-and-comparison-of-its-cost-in-robotic-vs-open-surgery-for-endometrial-cancer
#20
Reshu Agarwal, Anupama Rajanbabu, U G Unnikrishnan
To compare the usage and cost of analgesics (opioid and non-opioids), antiemetics, and IV fluids and its associated costs in robotic vs open staging surgery for endometrial cancer (EC). This retrospective study was performed at a single academic institution from January 2014 to June 2017 in the department of Gynecology Oncology at Amrita Institute of Medical Science, Kerala, India. The study included women with biopsy confirmed clinically early stage endometrial cancer or atypical hyperplasia, who underwent robotic-assisted or open staging surgery...
March 22, 2018: Journal of Robotic Surgery
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