Intravenous acetaminophen as an adjunct to multimodal analgesia after total knee and hip arthroplasty: A systematic review and meta-analysis

Pain control after the major orthopedic surgery has become a serious clinical problem. Although numerous analgesic methods have been applied, they have not provided sufficient relief from the pain. Therefore Liqing Yang et al performed a meta-analysis and reported that intravenous acetaminophen to multimodal analgesia could significantly reduce pain.

To examine the influence of additional intravenous Acetaminophen to manage pain appear after the total joint arthroplasty (TJA).

PubMed, ScienceDirect, the Cochrane Library, Medline, and Embase was searched and selected randomised controlled trials (RCTs) and non-RCTs. The quality evaluations were conducted as per the Cochrane systematic review method. Opioid consumption and postoperative pain scores were taken as the primary endpoints. Stata 11.0 software was used to perform the meta-analysis. 

Four studies comprising 865 participants were selected for the analysis. The meta-analysis revealed significant differences between groups regarding pain scores and opioid consumption at POD 1, POD 2, and POD 3. 

Additional intravenous Acetaminophen to multimodal analgesia could considerably lessen the pain and opioid intake following total joint arthroplasty with fewer adverse events. Greater quality RCTs are needed for more research.