Intravenous acetaminophen (paracetamol) for post craniotomy pain: systematic review
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Keywords
Intravenous acetaminophen, post craniotomy pain, patient-controlled analgesia (PCA), Opioids.
Abstract
Up to 80% of people who have craniotomies may have moderate to severe pain that lasts for many days after the procedure. Acetaminophen administered intravenously has been developed to manage pain in acute situations.
Aim: The purpose of the current research was to ascertain how intravenous paracetamol treatment affected individuals having elective craniotomies in terms of pain after the procedure.
Patients and methods: This systematic review included blinded or unblinded RCT either with parallel or cross-over design, human RCTs with patients undergoing craniotomy, the intervention group received IV paracetamol/acetaminophen, whereas a placebo or an active comparator was given to the comparison group. Two authors independently searched the online databases including Web of Science, Cochrane Library, Scopus MEDLINE, and EMBASE by combing MeSH and text keywords of "paracetamol and acetaminophen, I.V. intake, postoperative pain, craniotomy patients".
Results: The present study demonstrated that IV acetaminophen helps patients undergoing craniotomies have far less discomfort after surgery. The usage of opioids was not significantly reduced when IV acetaminophen was added to treat postoperative craniotomy pain. Within the first 24 hours after surgery, both groups had comparable timeframes to get rescue drugs, volumes of rescue medications, durations of stay in the ICU and hospital, numbers of successful neurological examinations, delirium, sedation, satisfaction ratings, VAS pain scores, and temperatures.
Conclusion: For patients having an elective craniotomy, intravenous paracetamol is a safe and effective way to manage postoperative pain; nevertheless, there are no advantages in terms of hospital stay, opioid need, or patient satisfaction.
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