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Shikatani Y, Soh J, Shien K, Kurosaki T, Ohtani S, Yamamoto H, Taniguchi A, Okazaki M, Sugimoto S, Yamane M, Oto T, Morimatsu H, Toyooka S. Effectiveness of scheduled intravenous acetaminophen in the postoperative pain management of video-assisted thoracic surgery. Surg Today 2020; 51:589-594. [PMID: 32880060 DOI: 10.1007/s00595-020-02127-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The scheduled administration of intravenous acetaminophen (scheduled-IV-AcA) is one of the more effective multimodal analgesic approaches for postoperative pain in abdominal/orthopedic surgeries. However, there is little evidence concerning scheduled-IV-AcA after general thoracic surgery, especially when limited to video-assisted thoracoscopic surgery (VATS). We investigated the efficacy of scheduled-IV-AcA administration in patients after undergoing VATS. METHODS Ninety-nine patients who underwent VATS lobectomy or segmentectomy via an 8-cm access window and 1 camera port were retrospectively reviewed by categorizing them into groups either with scheduled-IV-AcA (Group AcA: n = 29) or without it (Group non-AcA: n = 70). Group AcA received 1 g of IV-AcA every 6 h from the end of the operation until the end of POD2. Postoperative pain was measured using a numeric rating scale (NRS) three times per day until discharge. RESULTS NRS scores were significantly lower in Group AcA with motion (on POD1 to the first point of POD2) than in Group non-AcA. Group non-AcA was also more likely to use additional analgesics than Group AcA (39% vs. 17%, p = 0.058). CONCLUSIONS Scheduled-IV-AcA administration is a safe and effective multimodal analgesic approach in patients undergoing VATS pulmonary resection via an 8-cm access window.
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Affiliation(s)
- Yoshinobu Shikatani
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Junichi Soh
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan.
| | - Kazuhiko Shien
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Takeshi Kurosaki
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Shinji Ohtani
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Hiromasa Yamamoto
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Arata Taniguchi
- Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan
| | - Mikio Okazaki
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Seiichiro Sugimoto
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Masaomi Yamane
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Takahiro Oto
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
| | - Hiroshi Morimatsu
- Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan
| | - Shinichi Toyooka
- Department of General Thoracic, Breast and Endocrine Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, 700-8558, Japan
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