Routine use of I.V. acetaminophen not supported in open colectomy

Data from 2011–16 indicates that I.V. acetaminophen is not better than oral acetaminophen in curtailing opioid utilization in open colectomy. Researchers used a commercial health care database to identify 181,640 patients who underwent the procedure during that time frame, including about 25% who received I.V.

Data from 2011–16 indicates that I.V. acetaminophen is not better than oral acetaminophen in curtailing opioid utilization in open colectomy. Researchers used a commercial health care database to identify 181,640 patients who underwent the procedure during that time frame, including about 25% who received I.V. acetaminophen as part of their care. Opioid consumption fell 12.4% in those who were administered more than one dose of I.V. acetaminophen on the day of surgery, vs. 22.6% in those who took multiple doses by mouth on postoperative day one. Based on the findings, the researchers do not consider routine use of I.V. acetaminophen appropriate for open colectomy—especially considering the other analgesic options available. Expert reaction to the study, meanwhile, underscored the sometimes blind rush to embrace anything that promises to address the opioid crisis, even if the clinical evidence is not there to support. That is not to say that I.V. acetaminophen should never be used, they emphasize, noting its value under certain circumstances—such as when a patient cannot tolerate the oral formulation of acetaminophen. Rather than standard use, however, they say the decision to use I.V. acetaminophen should be based on informed clinical judgment and patient circumstances within the context of clinical pathways and protocols.