Department of Anesthesiology, Weill Cornell Medical College, 1300 York Avenue, Room A-1050, New York, NY, 10065, USA.
Department of Surgery, Weill Cornell Medical College, New York, NY, USA.
Obes Surg. 2018 Oct;28(10):2998-3006. doi: 10.1007/s11695-018-3316-7.
Retrospective studies indicate that acetaminophen iv administration reduces hospital length of stay (LoS) and opiate consumption in patients undergoing bariatric surgery.
This study sought to determine whether using acetaminophen iv in morbidly obese subjects undergoing sleeve gastrectomy decreased LoS and total hospital charges as compared to patients receiving saline placebo.
Single-center university hospital METHODS: Using a randomized, double-blind, placebo-controlled design, subjects were assigned to receive either acetaminophen iv (group A) or saline placebo iv (group P). Data were collected between Jan 1 and Dec 31, 2016. Group A received acetaminophen every 6 h for a total of four doses. The first dose was administered following the induction of general anesthesia; group P received saline iv on the same schedule. Anesthetic management and prophylactic antiemetic regimen were standardized in all subjects. Postoperative pain management consisted of hydromorphone via patient-controlled infusion pump. Primary outcomes include hospital LoS and associated hospital costs. Secondary outcomes include patient satisfaction and postoperative nausea and pain scores.
Subject demographics (n = 127) and intraoperative management were similar in the two groups. Across all subjects, median hospital LoS in group A (n = 63) was 1.87 vs. 1.97 days in group P (n = 64) (p = 0.03, Wilcoxon rank-sum test). Postoperatively, daily quality-of-recovery (QoR-15) scores, narcotic consumption, and the use of rescue antiemetics were not significantly different between groups. Median hospital costs were as follows: group A, $12,885 vs. group P, $12,977 (n = 64).
Acetaminophen iv may reduce hospital LoS in subjects undergoing sleeve gastrectomy.
回顾性研究表明，对接受减重手术的患者给予静脉注射对乙酰氨基酚可减少住院时间（ LOS ）和阿片类药物的消耗。
本研究旨在确定与接受生理盐水安慰剂的患者相比，在接受袖状胃切除术的病态肥胖患者中使用静脉注射对乙酰氨基酚是否会减少 LOS 和总住院费用。
单中心大学医院
使用随机、双盲、安慰剂对照设计，将受试者分为静脉注射对乙酰氨基酚组（A 组）或静脉注射生理盐水安慰剂组（P 组）。数据收集于 2016 年 1 月 1 日至 12 月 31 日。A 组每 6 小时接受一次对乙酰氨基酚，共 4 剂。第一剂在全身麻醉诱导后给予；P 组在相同的时间间隔内给予生理盐水 iv。所有受试者的麻醉管理和预防性止吐方案均标准化。术后疼痛管理包括通过患者自控输注泵给予氢吗啡酮。主要结局包括住院 LOS 和相关住院费用。次要结局包括患者满意度和术后恶心和疼痛评分。
两组患者的人口统计学特征（n=127）和术中管理相似。在所有受试者中，A 组（n=63）的中位住院 LOS 为 1.87 天，而 P 组（n=64）为 1.97 天（p=0.03，Wilcoxon 秩和检验）。术后，两组患者的每日恢复质量评分（QoR-15）、阿片类药物消耗量和使用止吐药解救的情况无显著差异。中位住院费用如下：A 组 12885 美元，P 组 12977 美元（n=64）。
静脉注射对乙酰氨基酚可能会减少接受袖状胃切除术的患者的住院时间。
