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Intravenous administration of Acetaminophen can be an effective preventive therapy for lowering the overall 24-hour opioid consumption after fusion surgery for adolescent idiopathic scoliosis (AIS).
In children and adolescents scheduled for posterior spinal fusion (PSF), IV Acetaminophen was found to be safe and reduces opioid use without elevated risk of adverse events according to a study issued in the Korean Journal of Anesthesiology.
Posterior spinal fusion (PSF), a common procedure for treating adolescent idiopathic scoliosis (AIS), often results in significant postoperative pain. While Acetaminophen given intravenously (IV) has shown potential for reducing opioid consumption, questions linger regarding its analgesic efficacy and optimal timing. This study sought to assess the impact of scheduled IV Acetaminophen on opioid intake and adverse events in children and adolescents (aged 11 to 20 years) undergoing PSF for effective pain relief.
Ninety-nine patients were randomized into 3 groups- the Preemptive group: Given Acetaminophen IV 15 mg/kg post anesthesia and prior to incision; the Preventive group: Given Acetaminophen IV 15 mg/kg at the end of the operation and prior to surgical-wound closure and; Placebo group. The use of opioids during the first 24 hours of the surgery was considered as the main study outcome.
The mean ± standard deviation (SD) amount of opioid intake was 60.66 ± 23.84 in the preemptive group, 52.23 ± 22.43 in the preventive group and 66.70 ± 23.01 mg in the placebo group. The preventive group had significantly lower opioid consumption than the placebo group (p = 0.013) as revealed from post hoc analysis. There were no notable variations found between the groups concerning the secondary outcomes.
Korean Journal of Anesthesiology
Comparison of preemptive and preventive intravenous Acetaminophen on opioid consumption in pediatrics undergoing posterior spinal fusion surgery: a randomized controlled trial.
Kim YJ et al.
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