Acetaminophen Shortens Duration of Opioid Treatment, Study Finds

Clinicians are looking for ways to reduce opioid exposure in a variety of settings. Could the use of acetaminophen before opioid use reduce the length of opioid treatment in a hospital setting?

Opioids can be a very effective way to manage pain, but with increasing monitoring of opioid use and duration, it has become imperative to find ways to reduce the duration of treatment. An investigation is examining whether the administration of intravenous acetaminophen before the introduction of opioids could reduce the duration of opioid treatment during inpatient care.1

Investigators conducted a comparative efficacy research study that examined data from pediatric inpatients from 274 hospitals in the United States between January 2011 and June 2016. They compared the results using a paired analysis by propensity score. Patients who received only intravenous opioids constituted the control cohort and those who received intravenous acetaminophen constituted the intervention group.

A group of 893,293 pediatric patients were included in the assessment, of which 287,504 received intravenous opioids and 18,197 received intravenous acetaminophen. Investigators removed patients who had not received intravenous opioids, those without diagnostic information, and those without hospital information, leaving 118,908 receiving intravenous opioids and 16,068 receiving intravenous acetaminophen. . In addition, patients who received acetaminophen after receiving opioids were also excluded.

Compared with patients who received opioids only, those who received acetaminophen followed by opioids were older (eg, 13 to 22 years old: 59.1% [1027 patients] against 56.4% [58 021 patients]) and not mechanically ventilated (97.4% [1693 patients] against 95.2% [97 858 patients]); and were more likely to have a body temperature above 38 ° C (3.1% [54 patients] against 1.7% [1706 patients]; P<.001>

After scoring the propensity match, the median duration of intravenous opioid use was 33.5 hours (5.4-74.0 hours) for the control group and for the intervention group was 27.7 hours (4.0-76.1 hours).

Investigators concluded that the use of intravenous acetaminophen prior to intravenous opioid administration was associated with a 15.5% reduction in the duration of opioid therapy. They believe that creating a pain management regimen that uses acetaminophen first could be a key way to reduce opioid exposure.

This article was originally published on Contemporary pediatrics.

Reference

1. Patel A, Gai J, Trujillo-Rivera E, et al. Association of intravenous acetaminophen administration with duration of intravenous opioid use in hospitalized pediatric patients. JAMA Netw Open. 2021; 4 (12): e2138420. doi: 10.1001 / jamanetworkopen.2021.38420

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