Acetaminophen May Decrease Opioid Use After Head and Neck Cancer Surgery

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The number of PCA attempts did not differ between treatment arms.
The number of PCA attempts did not differ between treatment arms.
The following article features coverage from the American Head & Neck Society (AHNS) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Intravenous (IV) acetaminophen may reduce opioid use after major surgery for head and neck cancer, according to an oral presentation given at the 2018 American Head & Neck Society Annual Meeting in National Harbor, Maryland.1

For this single-center prospective study, researchers assigned 48 patients undergoing head and neck cancer resection to receive IV acetaminophen 1 g every 6 hours plus the standard patient controlled analgesia (PCA) and other as-needed narcotic therapies. Outcomes were then compared with the historical outcomes of 51 patients who only received standard PCA and narcotics.

Patients who received acetaminophen received fewer total morphine equivalents (ME) post-surgically within the first 8 hours: the acetaminophen arm received 13.5 + 13.3 MEs compared with 22.5 + 21.5 MEs among patients who received standard care (P = .014).

No significant differences were observed in the total MEs received by both groups in the second and third 8-hour intervals after surgery, but a decrease in total IV MEs trended towards significance in the first 24 hours among patients in the acetaminophen arm (acetaminophen; 44.8 + 38.8 MEs vs standard; 64.7 + 60.2 MEs; P = .055).

Patients in the acetaminophen group also had a shorter length of hospital stay, with 7.8 + 4.6 days vs 10.6 + 7.6 days among patients in the non-acetaminophen arm (P = .03), approximately a 2-day improvement.

The number of PCA attempts did not differ between treatment arms, showing that the level of pain was similar between both study arms, though patients in the acetaminophen arm had equal pain relief with lower doses of narcotics.

The authors concluded that “future research should be aimed at comparing these groups in a randomized control study setting and looking at scheduled IV acetaminophen over a longer time period.”

Read more of Cancer Therapy Advisor's coverage of the American Head & Neck Society (AHNS) 2018 meeting by visiting the conference page.

Reference

  1. Smith EJ, Lange J, Moore C, Jackson L, Eid I, Monico J. The role of intravenous acetaminophen in post-operative pain control in head and neck cancer patients. Oral presentation at: 2018 American Head & Neck Society Annual Meeting; April 18-19, 2018; National Harbor, MD.

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