Pain, Postoperative, Spine Surgery
Conditions
Brief summary
Effective non-opioid analgesics are of particular interest in ambulatory surgery, as providers may be able to reduce pain while avoiding perioperative opioids that can delay same day discharge. The value of maintaining an efficient flow of patients from the perioperative area to discharge is an important metric for same day surgery centers, and an improvement in efficiency with IV acetaminophen could potentially offset the increased cost of the medication while providing a more pleasant surgical experience for patients. The goal of this study is to compare the efficacy of intraoperative IV administration vs. preoperative oral administration of acetaminophen on postoperative opioid utilization, patient-reported pain scores, opioid-related adverse effects, and time to recovery and discharge from the post-anesthesia care unit (PACU) after ambulatory lumbar discectomy.
Interventions
DRUGAcetaminophen
1000 mg of oral acetaminophen preoperatively administered
Sponsors
Rothman Institute Orthopaedics
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Only those performing postoperative assessments and the participants will be blinded.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age greater than 18 years-old * Weight greater than 50 kg body weight * ASA physical status I-III * English-speaking
Exclusion criteria
* Weight less than 50 kg * Pregnancy or breast feeding * revision surgery * Contraindications to the administration of acetaminophen (e.g. allergy, liver failure, etc) * Chronic pain conditions unrelated to back pain * Opioid tolerance ( defined as taking greater than oxycodone 20 mg daily for a week during the past month).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative opioid usage | 1 day | Postoperative opioid usage over the first 24 hours will be reported in IV morphine equivalents |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of recovery | 1 day | assessed using the Quality of Recovery 15 scale, with a range of 0-150 (0 is the worst score and 150 is the best possible recovery) |
| Number of patients who report nausea or vomiting | 1 day | this will be a count of the number of patients who report nausea or vomiting in recovery room |
| Mean pain score | 1 day | (0-10 numerical rating scale where 0=no pain and 10=worst pain imaginable) - this will be the mean pain rating upon entering pacu and at least 1 other time point in each study group |
Countries
United States
Outcome results
None listed