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Can IV Acetaminophen Offer an Option for Surgical Patients?


Health systems are looking for new options for pain management in the wake of the opioid epidemic.

The nation’s opioid epidemic has health systems looking for safer ways to provide pain relief while still helping patients achieve other goals, such as avoiding a hospital readmission.

A recent study from researchers at Duke University and the University of Washington School of Pharmacy has found that using intravenous (IV) acetaminophen to manage pain helped reduce opioid use, limit the chances of hospital readmission, and hold down costs.

The study was presented last week at the 28th annual National Forum of the Institute for Healthcare Improvement, held in Orlando, Florida, according to a statement from Mallinckrodt Pharmaceuticals, the maker of Ofirmev (injectable acetaminophen). The study compared outcomes among 190,691 patients who had total knee replacement from 2012 to 2015, including 56,475 (30%) who received IV acetaminophen.

Patients who received the IV acetaminophen as part of their pain management regimen had shorter length of stay in the hospital (2.8 days compared with 3.0 days). They were less likely to be readmitted in 30 days, less likely to be discharged to a skilled nursing facility, and more likely to be discharged home. They also had lower overall healthcare costs: $16,214.60 (SD = $6950.20) for the IV acetaminophen compared with $16,750.40 (SD = $9634.60) for those oral treatment only.

The finding that IV acetaminophen could be an effective treatment for pain management is important, given how many people become dependent on opioids after being prescribed the pills by a doctor. A study in The Journal of Pain found that 27% of those reporting chronic opioid use said they started using the pills after surgery and another 27% started using them after an acute injury. Deaths from opioid abuse have increased 200% since 2000, and last week the CDC reported the opioid crisis is a reason that US life expectancy dropped for the first time since 1993.


Pham AT, Hansen R, Boing EA, Triple aim as a conceptual framework for conducting comparative effectiveness research in postoperative pain. Presented at the 28th Annual National Forum for the Institute for Healthcare Improvement, Orlando, Florida. December 4-7, 2016. Poster 194.

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