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Assessing Efficacy of Intravenous Acetaminophen for Perioperative Pain Treatment in Spinal Surgery

Phase 2
Completed
Conditions
Lumbar; Injury
Interventions
Drug: Placebo
Registration Number
NCT05764707
Lead Sponsor
Massachusetts General Hospital
Brief Summary

Spinal surgeries are generally associated with intense pain in the postoperative period, especially for the initial few days. The aim of this study is to examine the effect of intraoperative intravenous acetaminophen in spine surgery on postoperative analgesic requirements, pain scores, patient satisfaction, and clinical recovery. Enrolled patients are randomized to receive either intravenous acetaminophen or placebo at the time of surgical closure. It is hypothesized that patients receiving intravenous acetaminophen will have improved pain scores, require less opiate medication, and have better patient satisfaction than those receiving placebo.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Patients undergoing 1-2 levels primary spine surgery ≥18 years old
Exclusion Criteria
  • Chronic opiate users
  • More than 3 levels or revision spine surgery
  • Liver disease patients include elevated LFT, hepatitis A, hepatitis B or hepatitis C, cirrhosis, fatty liver disease, and any other liver diseases caused by drugs, poisons, or alcohol(s)
  • Allergy/hypersensitivity to acetaminophen
  • Patients that have used acetaminophen during the 24 hours before their scheduled surgery

Subjects who were unable to communicate in English were further excluded because of their inability to complete the postoperative questionnaires

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intravenous PlaceboPlaceboIntravenous normal saline will be administered within 30 minutes of skin closure.
Intravenous AcetaminophenAcetaminophenIntravenous acetaminophen (1000mg) will be administered within 30 minutes of skin closure.
Primary Outcome Measures
NameTimeMethod
Worst pain score in the post-anesthesia care unitTime of postoperative care unit discharge readiness, approximately 3 hours

The primary outcome will assess worst pain score at the time the patient is ready for post anesthesia care unit discharge using the Revised American Pain Society Patient Outcome Questionnaire. This scale ranges from 0 to 10, with higher values reporting more pain.

Secondary Outcome Measures
NameTimeMethod
Postoperative pain scoresPostoperatively until 72 hours or discharge, approximately three days

Pain scores will be collected for the first 72 hours or up until discharge, whichever comes first, using clinically documented nursing pain scores. Values will be collected on a scale from 0 to 10 with higher values indicating increased (worst) pain.

Intraoperative opioid consumptionIntraoperatively

Total cumulative morphine equivalents will be reported while the patient is in the operating room.

Postoperative opioid consumption in the post anesthesia care unitPostoperatively until time of PACU discharge, approximately 3 hours.

Total cumulative morphine equivalents will be reported while the patient is in the post anesthesia care unit.

Time to rescue analgesiaPostoperatively until discharge, an average of two days

The time to rescue analgesia (in minutes) will be assessed.

Postoperative opioid consumption after discharge from the postoperative careTime of discharge from the postoperative care unit until discharge from the hospital, an average of two days

Total cumulative morphine equivalents will be reported starting from the time the patient is discharged from the post anesthesia care unit until they are discharged from the hospital.

Patient satisfactionTime of postoperative care unit discharge readiness, approximately 3 hours.

Satisfaction with the patient's pain treatment in the hospital will be assessed at the time the patient is ready for discharge from the post anesthesia care unit using the Revised American Pain Society Patient Outcome Questionnaire. This scale ranges from 0 (extremely dissatisfied) to 10 (extremely satisfied).

Length of hospital stayPostoperatively until discharge, an average of two days

Length of hospital stay (in days) will be reported.

Trial Locations

Locations (1)

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

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