Postoperative Pain Clinical Trial
Official title:
A Comparison of IV Versus PO Acetaminophen Postoperatively for Opioid Consumption After Cesarean Section
This randomized controlled study will compare narcotic consumption between two groups: patients that receive a perioperative dose of IV acetaminophen versus patients that receive a perioperative dose of oral liquid acetaminophen for scheduled cesarean section.
"Enhanced recovery" is an alternate management protocol described by a multi-modal, evidence
based approach to peri-operative care, with the goal of accelerating recovery and return to
normal activity after surgery. Results have shown stable pain control with a decrease in
narcotic consumption, a quicker return of bowel function, and decreased length of hospital
stay and cost with no change in level of patient satisfaction, morbidity, or readmission
rate. An aspect of some alternate management protocols is the administration of
acetaminophen.
The concentration of acetaminophen in cerebrospinal fluid (CSF) is directly proportional to
the analgesic activity of acetaminophen. Acetaminophen relies on a high concentration
gradient from the plasma to the CSF in order to passively diffuse into the central nervous
system (CNS), its principal site of action. A 2012 study, comparing plasma and CSF
pharmacokinetics of intravenous (IV), oral (PO), or rectal (PR) acetaminophen, concluded that
IV administration of acetaminophen results in higher plasma and CSF concentration values.
Therefore, IV acetaminophen produces better CNS penetration compared to PO or PR methods.
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