Acute Pain Management with Intravenous Paracetamol
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Published:
Jul 19, 2019
Keywords:
acute pain management, intravenous, paracetamol
Main Article Content
Abstract
Multimodal approach is commonly used in acute pain
management. Intravenous paracetamol is an efficacious,
safe treatment and also reduces opioid consumption.
Combination of intravenous paracetamol, NSAIDs and
COXIBs provides better analgesia than each drug when
used separately. Preemptive and preventive analgesia
with intravenous paracetamol are providing better
postoperative pain without neonatal complications in
women undergoing cesarean section. Furthermore,
prophylactic intravenous paracetamol reduces postoperative
nausea and vomiting.
Article Details
Section
Review articles
References
References
1. Ong CK, Seymour RA, Lirk P, Merry AF. Combining
paracetamol (acetaminophen) with nonsteroidal
antiinflammatory drugs: a qualitative systematic review of
analgesic efficacy for acute postoperative pain. Anesth
Analg 2010;110(4):1170-9.
2. Kraglund F. Acetaminophen plus a nonsteroidal
anti-inflammatory drug decreases acute postoperative pain
more than either drug alone. J Am Dent Assoc 2014;
145(9):966-8.
3. Oscier CD, Milner QJ. Paracetamol: a review of three routes
of administration. Update in anaesthesia. 2007 [cited 2019
Jan 10]. Available from: https://www.scribd.com/document/
189209520/Paracetamol-a-Review-of-Three-Routes-of-Administration
4. Jibril F, Sharaby S, Mohamed A, Wilby KJ. Intravenous versus
Oral Acetaminophen for Pain: Systematic Review of Current
Evidence to Support Clinical Decision-Making. Can J Hosp
Pharm 2015;68(3):238-47.
5. Sinatra RS, Jahr JS, Reynolds LW, Viscusi ER, Groudine SB,
Payen-Champenois C. Efficacy and safety of single and
repeated administration of 1 gram intravenous acetaminophen
injection (paracetamol) for pain management after major
orthopedic surgery. Anesthesiology 2005;102(4):822-31.
6. Remy C, Marret E, Bonnet F. Bonnet. Effects of acetaminophen
on morphine side-effects and consumption after major
surgery: meta-analysis of randomized controlled trials. Br J
Anaesth 2005;94(4):505-13.
122
7. Peduto VA, Ballabio M, Stefanini S. Efficacy of propacetamol
in the treatment of postoperative pain. Morphine-sparing
effect in orthopedic surgery. Acta Anaesthesiol Scand 1998;
42:293-8.
8. Delbos A, Boccard E. The morphine-sparing effect of
propacetamol in orthopedic postoperative pain. J Pain
Symptom Manage 1995;10:279-86.
9. Cobby TF, Crighton IM, Kyriakides K, Hobbs GJ. Rectal
paracetamol has a significant morphine-sparing effect after
hysterectomy. Br J Anaesth 1999;83:253-6.
10. Jelacic S, Bollag L, Bowdle A, Rivat C, Cain KC, Richebe P.
Intravenous Acetaminophen as an Adjunct Analgesic in
Cardiac Surgery Reduces Opioid Consumption But Not
Opioid-Related Adverse Effects: A Randomized Controlled
Trial. J Cardiothorac Vasc Anesth 2016;30(4):997-1004.
11. McNicol ED, Ferguson MC, Haroutounian S, Carr DB,
Schumann R. Single dose intravenous paracetamol or
intravenous propacetamol for postoperative pain. Cochrane
Database Syst Rev. 2016 [cited 2019 Jan 12]. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353081/pdf/
CD007126.pdf
12. Maghsoudi R, Tabatabai M, Radfar MH, et al. Opioid-sparing
effect of intravenous paracetamol after percutaneous
nephrolithotomy: a double-blind randomized controlled trial
Journal of Endourology. 2014;28:23-7.
13. จันทนี อิทธิพานิชพงศ์. ยาแก้ปวดลดไข้และยาต้านการอักเสบ. ใน:
คณาจารย์ภาควิชาเภสัชวิทยา, บรรณาธิการ. เภสัชวิทยา. พิมพ์
ครั้งที่ 4. กรุงเทพฯ: โรงพิมพ์แห่งจุฬาลงกรณ์มหาวิทยาลัย; 2550.
14. Courade JP, Caussade F, Martin K, et al. Effects of
acetaminophen on monoaminergic systems in the rat central
nervous system. Naunyn Schmiedebergs Arch Pharmacol
2001;364:534-7.
15. Pelissier T, Alloui A, Caussade F, et al. Paracetamol exerts
a spinal antinociceptive effect involving an indirect
interaction with 5-hydroxytryptamine3 receptors: in vivo and
in vitro evidence. J Pharmacol Exp Ther 1996;278:8-14.
16. Tjølsen A, Lund A, Hole K. Antinociceptive effect of
paracetamol in rats is partly dependent on spinal
serotonergic systems. Eur J Pharmacol 1991;193:193-201.
17. Pini LA, Sandrini M, Vitale G. The antinociceptive action of
paracetamol is associated with changes in the serotonergic
system in the rat brain. Eur J Pharmacol 1996;308:31-40.
18. Holmér Pettersson P, Owall A, Jakobsson J. Early
bioavailability of paracetamol after oral or intravenous
administration. Acta Anaesthesiol Scand 2004;48(7):867-70.
19. Jarde O, Boccard E. Parenteral versus oral route increases
paracetamol efficacy. Clin Drug Investig 1997;14:474-81.
20. Politi JR, Davis RL, Matrka AK. Randomized Prospective
Trial Comparing the Use of Intravenous versus Oral
Acetaminophen in Total Joint Arthroplasty. J Arthroplasty
2017;32(4):1125-7.
21. Fenlon S, Collyer J, Giles J, et al. Oral vs intravenous
paracetamol for lower third molar extractions under general
anaesthesia: is oral administration inferior? Br J Anaesth
2013;110(3):423-7.
22. O’Neal JB, Freiberg AA, Yelle MD, et al. Intravenous vs Oral
Acetaminophen as an Adjunct to Multimodal Analgesia After
Total Knee Arthroplasty: A Prospective, Randomized,
Double-Blind Clinical Trial. J Arthroplasty 2017;32(10):3029-
33.
23. Sun L, Zhu X, Zou J, Li Y, Han W. Comparison of intravenous
and oral acetaminophen for pain control after total knee and
hip arthroplasty: A systematic review and meta-analysis.
Medicine (Baltimore) 2018;97(6):e9751.
24. Caldeira D, Costa J, Barra M, Pinto FJ, Ferreira JJ. How safe
is acetaminophen use in patients treated with vitamin K
antagonists? A systematic review and meta-analysis. Thromb
Res 2015;135(1):58-61.
25. Numata T, Fukushi R, Ito T, Tsuboi R, Harada K. Acetaminophen
anaphylaxis diagnosed by skin prick test. Allergol Int
2016;65(4):490-1.
26. de Paramo BJ, Gancedo SQ, Cuevas M, Camo IP, Martin JA,
Cosmes EL. Paracetamol (acetaminophen) hypersensitivity.
Ann Allergy Asthma Immunol 2000;85((6 Pt 1)):508-11.
27. Rutkowski K, Nasser SM, Ewan PW. Paracetamol
hypersensitivity: clinical features, mechanism and role of
specific IgE. Int Arch Allergy Immunol 2012;159(1):60-4.
28. Forget P, Wittebole X, Laterre PF. Therapeutic dose of
acetaminophen may induce fulminant hepatitis in the
presence of risk factors: a report of two cases. Br J Anaesth
2009;103(6):899-900.
29. Chhaya VS, Vivek M. Paracetamol: mechanisms and
updates. Continuing Education in Anaesthesia Critical Care
& Pain 2014;14(4):153-8.
30. Bougie D, Aster R, Immune thrombocytopenia resulting from
sensitivity to metabolites of naproxen and acetaminophen.
Blood 2001;97(12):3846-50.
31. Chiam E, Weinberg L, Bellomo R. Paracetamol: a review with
specific focus on the haemodynamic effects of intravenous
administration. Heart Lung Vessel 2015;7(2):121-32.
32. Huang PS, Gleason SM, Shah JA, Buros AF, Hoffman DA.
Efficacy of Intravenous Acetaminophen for Postoperative
Analgesia in Primary Total Knee Arthroplasty. J Arthroplasty
2018;33(4):1052-6.
33. Liang L, Cai Y, Li A, Ma C. The efficiency of intravenous
acetaminophen for pain control following total knee and hip
arthroplasty: A systematic review and meta-analysis.
Medicine (Baltimore) 2017;96(46):e8586.
34. Elseify ZA, El-Khattab SO, Khattab AM, Atta EM, Ajjoub LF.
Combined parecoxib and I.V. paracetamol provides
additional analgesic effect with better postoperative
satisfaction in patients undergoing anterior cruciate ligament
reconstruction. Saudi J Anaesth 2011;5(1):45-9.
35. Rasmussen GL, Steckner K, Hogue C, Torri S, Hubbard RC.
Intravenous parecoxib sodium foracute pain after orthopedic
knee surgery. Am J Orthop 2002;31(6):336-43.
36. Nong L, Sun Y, Tian Y, Li H, Li H. Effects of parecoxib on
morphine analgesia after gynecology tumor operation: a
randomized trial of parecoxib used in postsurgical pain
management. J Surg Res 2013;183(2):821-6.
37. Khalili G , Janghorbani M, Saryazdi H, Emaminejad A. Effect
of preemptive and preventive acetaminophen on
postoperative pain score: a randomized, double-blind trial
of patients undergoing lower extremity surgery. J Clin Anesth
2013;25(3):188-92.
38. Kharouba J, Hawash N, Peretz B, et al. Effect of intravenous
paracetamol as pre-emptive compared to preventive
analgesia in a pediatric dental setting: a prospective
randomized study. Int J Paediatr Dent 2018;28(1):83-91.
39. Sadrolsadat SH, Yousefshahi F, Ostadalipour A, Mohammadi
FZ, Makarem J. Effect of Intravenous Acetaminophen on
Postoperative Pain in Vitrectomy: A Randomized, Double-Blind,
Clinical Trial. Anesth Pain Med 2017;30(7):e13639.
40. Hassan HI. Perioperative analgesic effects of intravenous
paracetamol: Preemptive versus preventive analgesia in
elective cesarean section. Anesth Essays Res 2014;8(3):
339-44.
41. Ayatollahi V, Faghihi S, Behdad S, Heiranizadeh N,
Baghianimoghadam B. Effect of preoperative administration
of intravenous paracetamol during cesarean surgery on
hemodynamic variables relative to intubation, postoperative
pain and neonatal apgar. Acta Clin Croa 2014;53(3):272-8.
42. Majumdar S, Das A, Kundu R, Mukherjee D, Hazra B, Mitra
T. Intravenous paracetamol infusion: Superior pain
management and earlier discharge from hospital in patients
undergoing palliative head-neck cancer surgery. Perspect
Clin Res 2014;5(4):172-7.
43. Mohammad J, Ali M, Mojtaba S, Arash S. Efficacy of
Intravenous Paracetamol Versus Intravenous Morphine in
Acute Limb Trauma. Trauma Mon 2016;21(1):e19649
44. Serinken M, Eken C, Turkcuer I, Elicabuk H, Uyanik E, Schultz
CH. Intravenous paracetamol versus morphine for renal
colic in the emergency department: a randomised double-blind
controlled trial. Emerg Med J 2012;29(11):902-5.
45. Bektas F, Eken C, Karadeniz O, Goksu E, Cubuk M, Cete Y.
Intravenous paracetamol or morphine for the treatment of
renal colic: a randomized, placebo-controlled trial. Ann
Emerg Med 2009;54(4):568-74.
46. Pathan SA, Mitra B, Cameron PA. A Systematic Review and
Meta-analysis Comparing the Efficacy of Nonsteroidal
Anti-inflammatory Drugs, Opioids, and Paracetamol in the
Treatment of Acute Renal Colic. Eur Urol 2018;73(4):583-95.
47. Sin B, Koop K, Liu M, Yeh JY, Thandi P. Intravenous
Acetaminophen for Renal Colic in the Emergency
Department: Where Do We Stand? Am J Ther 2017;24(1):e12-
e9.
48. Apfel CC, Turan A, Souza K, Pergolizzi J, Hornuss C.
Intravenous acetaminophen reduces postoperative nausea
and vomiting: A systematic review and meta-analysis. Pain
2013;154(5):677-89.
1. Ong CK, Seymour RA, Lirk P, Merry AF. Combining
paracetamol (acetaminophen) with nonsteroidal
antiinflammatory drugs: a qualitative systematic review of
analgesic efficacy for acute postoperative pain. Anesth
Analg 2010;110(4):1170-9.
2. Kraglund F. Acetaminophen plus a nonsteroidal
anti-inflammatory drug decreases acute postoperative pain
more than either drug alone. J Am Dent Assoc 2014;
145(9):966-8.
3. Oscier CD, Milner QJ. Paracetamol: a review of three routes
of administration. Update in anaesthesia. 2007 [cited 2019
Jan 10]. Available from: https://www.scribd.com/document/
189209520/Paracetamol-a-Review-of-Three-Routes-of-Administration
4. Jibril F, Sharaby S, Mohamed A, Wilby KJ. Intravenous versus
Oral Acetaminophen for Pain: Systematic Review of Current
Evidence to Support Clinical Decision-Making. Can J Hosp
Pharm 2015;68(3):238-47.
5. Sinatra RS, Jahr JS, Reynolds LW, Viscusi ER, Groudine SB,
Payen-Champenois C. Efficacy and safety of single and
repeated administration of 1 gram intravenous acetaminophen
injection (paracetamol) for pain management after major
orthopedic surgery. Anesthesiology 2005;102(4):822-31.
6. Remy C, Marret E, Bonnet F. Bonnet. Effects of acetaminophen
on morphine side-effects and consumption after major
surgery: meta-analysis of randomized controlled trials. Br J
Anaesth 2005;94(4):505-13.
122
7. Peduto VA, Ballabio M, Stefanini S. Efficacy of propacetamol
in the treatment of postoperative pain. Morphine-sparing
effect in orthopedic surgery. Acta Anaesthesiol Scand 1998;
42:293-8.
8. Delbos A, Boccard E. The morphine-sparing effect of
propacetamol in orthopedic postoperative pain. J Pain
Symptom Manage 1995;10:279-86.
9. Cobby TF, Crighton IM, Kyriakides K, Hobbs GJ. Rectal
paracetamol has a significant morphine-sparing effect after
hysterectomy. Br J Anaesth 1999;83:253-6.
10. Jelacic S, Bollag L, Bowdle A, Rivat C, Cain KC, Richebe P.
Intravenous Acetaminophen as an Adjunct Analgesic in
Cardiac Surgery Reduces Opioid Consumption But Not
Opioid-Related Adverse Effects: A Randomized Controlled
Trial. J Cardiothorac Vasc Anesth 2016;30(4):997-1004.
11. McNicol ED, Ferguson MC, Haroutounian S, Carr DB,
Schumann R. Single dose intravenous paracetamol or
intravenous propacetamol for postoperative pain. Cochrane
Database Syst Rev. 2016 [cited 2019 Jan 12]. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353081/pdf/
CD007126.pdf
12. Maghsoudi R, Tabatabai M, Radfar MH, et al. Opioid-sparing
effect of intravenous paracetamol after percutaneous
nephrolithotomy: a double-blind randomized controlled trial
Journal of Endourology. 2014;28:23-7.
13. จันทนี อิทธิพานิชพงศ์. ยาแก้ปวดลดไข้และยาต้านการอักเสบ. ใน:
คณาจารย์ภาควิชาเภสัชวิทยา, บรรณาธิการ. เภสัชวิทยา. พิมพ์
ครั้งที่ 4. กรุงเทพฯ: โรงพิมพ์แห่งจุฬาลงกรณ์มหาวิทยาลัย; 2550.
14. Courade JP, Caussade F, Martin K, et al. Effects of
acetaminophen on monoaminergic systems in the rat central
nervous system. Naunyn Schmiedebergs Arch Pharmacol
2001;364:534-7.
15. Pelissier T, Alloui A, Caussade F, et al. Paracetamol exerts
a spinal antinociceptive effect involving an indirect
interaction with 5-hydroxytryptamine3 receptors: in vivo and
in vitro evidence. J Pharmacol Exp Ther 1996;278:8-14.
16. Tjølsen A, Lund A, Hole K. Antinociceptive effect of
paracetamol in rats is partly dependent on spinal
serotonergic systems. Eur J Pharmacol 1991;193:193-201.
17. Pini LA, Sandrini M, Vitale G. The antinociceptive action of
paracetamol is associated with changes in the serotonergic
system in the rat brain. Eur J Pharmacol 1996;308:31-40.
18. Holmér Pettersson P, Owall A, Jakobsson J. Early
bioavailability of paracetamol after oral or intravenous
administration. Acta Anaesthesiol Scand 2004;48(7):867-70.
19. Jarde O, Boccard E. Parenteral versus oral route increases
paracetamol efficacy. Clin Drug Investig 1997;14:474-81.
20. Politi JR, Davis RL, Matrka AK. Randomized Prospective
Trial Comparing the Use of Intravenous versus Oral
Acetaminophen in Total Joint Arthroplasty. J Arthroplasty
2017;32(4):1125-7.
21. Fenlon S, Collyer J, Giles J, et al. Oral vs intravenous
paracetamol for lower third molar extractions under general
anaesthesia: is oral administration inferior? Br J Anaesth
2013;110(3):423-7.
22. O’Neal JB, Freiberg AA, Yelle MD, et al. Intravenous vs Oral
Acetaminophen as an Adjunct to Multimodal Analgesia After
Total Knee Arthroplasty: A Prospective, Randomized,
Double-Blind Clinical Trial. J Arthroplasty 2017;32(10):3029-
33.
23. Sun L, Zhu X, Zou J, Li Y, Han W. Comparison of intravenous
and oral acetaminophen for pain control after total knee and
hip arthroplasty: A systematic review and meta-analysis.
Medicine (Baltimore) 2018;97(6):e9751.
24. Caldeira D, Costa J, Barra M, Pinto FJ, Ferreira JJ. How safe
is acetaminophen use in patients treated with vitamin K
antagonists? A systematic review and meta-analysis. Thromb
Res 2015;135(1):58-61.
25. Numata T, Fukushi R, Ito T, Tsuboi R, Harada K. Acetaminophen
anaphylaxis diagnosed by skin prick test. Allergol Int
2016;65(4):490-1.
26. de Paramo BJ, Gancedo SQ, Cuevas M, Camo IP, Martin JA,
Cosmes EL. Paracetamol (acetaminophen) hypersensitivity.
Ann Allergy Asthma Immunol 2000;85((6 Pt 1)):508-11.
27. Rutkowski K, Nasser SM, Ewan PW. Paracetamol
hypersensitivity: clinical features, mechanism and role of
specific IgE. Int Arch Allergy Immunol 2012;159(1):60-4.
28. Forget P, Wittebole X, Laterre PF. Therapeutic dose of
acetaminophen may induce fulminant hepatitis in the
presence of risk factors: a report of two cases. Br J Anaesth
2009;103(6):899-900.
29. Chhaya VS, Vivek M. Paracetamol: mechanisms and
updates. Continuing Education in Anaesthesia Critical Care
& Pain 2014;14(4):153-8.
30. Bougie D, Aster R, Immune thrombocytopenia resulting from
sensitivity to metabolites of naproxen and acetaminophen.
Blood 2001;97(12):3846-50.
31. Chiam E, Weinberg L, Bellomo R. Paracetamol: a review with
specific focus on the haemodynamic effects of intravenous
administration. Heart Lung Vessel 2015;7(2):121-32.
32. Huang PS, Gleason SM, Shah JA, Buros AF, Hoffman DA.
Efficacy of Intravenous Acetaminophen for Postoperative
Analgesia in Primary Total Knee Arthroplasty. J Arthroplasty
2018;33(4):1052-6.
33. Liang L, Cai Y, Li A, Ma C. The efficiency of intravenous
acetaminophen for pain control following total knee and hip
arthroplasty: A systematic review and meta-analysis.
Medicine (Baltimore) 2017;96(46):e8586.
34. Elseify ZA, El-Khattab SO, Khattab AM, Atta EM, Ajjoub LF.
Combined parecoxib and I.V. paracetamol provides
additional analgesic effect with better postoperative
satisfaction in patients undergoing anterior cruciate ligament
reconstruction. Saudi J Anaesth 2011;5(1):45-9.
35. Rasmussen GL, Steckner K, Hogue C, Torri S, Hubbard RC.
Intravenous parecoxib sodium foracute pain after orthopedic
knee surgery. Am J Orthop 2002;31(6):336-43.
36. Nong L, Sun Y, Tian Y, Li H, Li H. Effects of parecoxib on
morphine analgesia after gynecology tumor operation: a
randomized trial of parecoxib used in postsurgical pain
management. J Surg Res 2013;183(2):821-6.
37. Khalili G , Janghorbani M, Saryazdi H, Emaminejad A. Effect
of preemptive and preventive acetaminophen on
postoperative pain score: a randomized, double-blind trial
of patients undergoing lower extremity surgery. J Clin Anesth
2013;25(3):188-92.
38. Kharouba J, Hawash N, Peretz B, et al. Effect of intravenous
paracetamol as pre-emptive compared to preventive
analgesia in a pediatric dental setting: a prospective
randomized study. Int J Paediatr Dent 2018;28(1):83-91.
39. Sadrolsadat SH, Yousefshahi F, Ostadalipour A, Mohammadi
FZ, Makarem J. Effect of Intravenous Acetaminophen on
Postoperative Pain in Vitrectomy: A Randomized, Double-Blind,
Clinical Trial. Anesth Pain Med 2017;30(7):e13639.
40. Hassan HI. Perioperative analgesic effects of intravenous
paracetamol: Preemptive versus preventive analgesia in
elective cesarean section. Anesth Essays Res 2014;8(3):
339-44.
41. Ayatollahi V, Faghihi S, Behdad S, Heiranizadeh N,
Baghianimoghadam B. Effect of preoperative administration
of intravenous paracetamol during cesarean surgery on
hemodynamic variables relative to intubation, postoperative
pain and neonatal apgar. Acta Clin Croa 2014;53(3):272-8.
42. Majumdar S, Das A, Kundu R, Mukherjee D, Hazra B, Mitra
T. Intravenous paracetamol infusion: Superior pain
management and earlier discharge from hospital in patients
undergoing palliative head-neck cancer surgery. Perspect
Clin Res 2014;5(4):172-7.
43. Mohammad J, Ali M, Mojtaba S, Arash S. Efficacy of
Intravenous Paracetamol Versus Intravenous Morphine in
Acute Limb Trauma. Trauma Mon 2016;21(1):e19649
44. Serinken M, Eken C, Turkcuer I, Elicabuk H, Uyanik E, Schultz
CH. Intravenous paracetamol versus morphine for renal
colic in the emergency department: a randomised double-blind
controlled trial. Emerg Med J 2012;29(11):902-5.
45. Bektas F, Eken C, Karadeniz O, Goksu E, Cubuk M, Cete Y.
Intravenous paracetamol or morphine for the treatment of
renal colic: a randomized, placebo-controlled trial. Ann
Emerg Med 2009;54(4):568-74.
46. Pathan SA, Mitra B, Cameron PA. A Systematic Review and
Meta-analysis Comparing the Efficacy of Nonsteroidal
Anti-inflammatory Drugs, Opioids, and Paracetamol in the
Treatment of Acute Renal Colic. Eur Urol 2018;73(4):583-95.
47. Sin B, Koop K, Liu M, Yeh JY, Thandi P. Intravenous
Acetaminophen for Renal Colic in the Emergency
Department: Where Do We Stand? Am J Ther 2017;24(1):e12-
e9.
48. Apfel CC, Turan A, Souza K, Pergolizzi J, Hornuss C.
Intravenous acetaminophen reduces postoperative nausea
and vomiting: A systematic review and meta-analysis. Pain
2013;154(5):677-89.