TY - JOUR
T1 - Continuous Multimechanistic Postoperative Analgesia
T2 - A Rationale for Transitioning from Intravenous Acetaminophen and Opioids to Oral Formulations
AU - Pergolizzi, Joseph V.
AU - Raffa, Robert B.
AU - Tallarida, Ronald
AU - Taylor, Robert
AU - Labhsetwar, Sumedha A.
PY - 2012/2
Y1 - 2012/2
N2 - Good surgical outcomes depend in part on good pain relief, allowing for early mobilization, optimal recovery, and patient satisfaction. Postsurgical pain has multiple mechanisms, and multimechanistic approaches to postoperative analgesia are recommended and may be associated with improved pain relief, lowered opioid doses, and sometimes a lower rate of opioid-associated side effects. Acetaminophen (paracetamol) is a familiar agent for treating many types of pain, including postsurgical pain. Oral acetaminophen has been shown to be safe and effective in a variety of acute pain models. Combination products using a fixed-dose of acetaminophen and an opioid have also been effective in treating postsurgical pain. Combination products with acetaminophen have demonstrated an opioid-sparing effect, which inconsistently results in a reduced rate of opioid-associated side effects. Intravenous (IV) acetaminophen and an opioid analgesic administered in the perioperative period may be followed by an oral acetaminophen and opioid combination in the postoperative period. Transitioning from an IV acetaminophen and opioid formulation to a similar but oral formulation of the same drugs appears to be a reasonable step in that both analgesic therapies are known to be safe and effective. For postsurgical analgesia with any acetaminophen product, patient education is necessary to be sure that the patient does not concurrently take any over-the-counter products containing acetaminophen and accidentally exceed dose limits.
AB - Good surgical outcomes depend in part on good pain relief, allowing for early mobilization, optimal recovery, and patient satisfaction. Postsurgical pain has multiple mechanisms, and multimechanistic approaches to postoperative analgesia are recommended and may be associated with improved pain relief, lowered opioid doses, and sometimes a lower rate of opioid-associated side effects. Acetaminophen (paracetamol) is a familiar agent for treating many types of pain, including postsurgical pain. Oral acetaminophen has been shown to be safe and effective in a variety of acute pain models. Combination products using a fixed-dose of acetaminophen and an opioid have also been effective in treating postsurgical pain. Combination products with acetaminophen have demonstrated an opioid-sparing effect, which inconsistently results in a reduced rate of opioid-associated side effects. Intravenous (IV) acetaminophen and an opioid analgesic administered in the perioperative period may be followed by an oral acetaminophen and opioid combination in the postoperative period. Transitioning from an IV acetaminophen and opioid formulation to a similar but oral formulation of the same drugs appears to be a reasonable step in that both analgesic therapies are known to be safe and effective. For postsurgical analgesia with any acetaminophen product, patient education is necessary to be sure that the patient does not concurrently take any over-the-counter products containing acetaminophen and accidentally exceed dose limits.
KW - Acetaminophen
KW - Intravenous acetaminophen
KW - Intravenous paracetamol
KW - Paracetamol
KW - Postsurgical pain management
UR - http://www.scopus.com/inward/record.url?scp=84856571039&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84856571039&partnerID=8YFLogxK
U2 - 10.1111/j.1533-2500.2011.00476.x
DO - 10.1111/j.1533-2500.2011.00476.x
M3 - Article
C2 - 21676161
AN - SCOPUS:84856571039
SN - 1530-7085
VL - 12
SP - 159
EP - 173
JO - Pain Practice
JF - Pain Practice
IS - 2
ER -