Oral Acetaminophen as Efficacious as IV Formulation for Postoperative Pain-and Much Less Costly

In a double-blind randomized trial of 74 women undergoing robotic-assisted laparoscopic hysterectomy for benign indications, participants received either acetaminophen 1 g orally, then normal saline 100 mL intravenously, before surgery, or a placebo orally, then acetaminophen 1 g intravenously.

No difference in average pain score was noted 2 hours after surgery, nor at any of the measured time points. Of the participants, 38% in the oral group and 19% in the intravenous group experienced nausea (P = 0.12). On average, the oral group requested analgesia in 45 minutes and the IV group in 43 minutes.

The authors concluded that no difference in pain was observed 2 hours postoperatively when comparing preoperative administration of oral compared with IV acetaminophen. The ease of administration and lower cost of oral dosing support the oral route as part of the enhanced recovery protocol after minimally invasive gynecologic surgery. (See Lombardi TM, Kahn BS, Tsai LJ, et al. Preemptive oral compared with intravenous acetaminophen for postoperative pain after robotic-assisted laparoscopic hysterectomy: a randomized controlled trial. Obstet Gynecol. 2019;134(6):1293-1297. doi:10.1097/AOG.0000000000003578.)