Impact of Preoperative Oral Acetaminophen Administration on Postoperative Opioid Consumption and Complications in Laparoscopic Sleeve Gastrectomy: A Pilot Study

Background: Opioids are a mainstay for postoperative pain following laparoscopic sleeve gastrectomy (SG). Though effective, opioids are not without risk of adverse events. Preoperative analgesia used to reduce opioid consumption includes intravenous acetaminophen (APAP).

Objectives: This study aimed to evaluate the impact of preoperative oral APAP on postoperative opioid use and complications.

Setting: Educational hospital in the United States of America (USA)

Methods: This was a retrospective study comparing patients who received 975 mg oral APAP preoperatively (APAP group) to a historical control (C group) that did not receive preoperative APAP. The primary outcome was hydromorphone equivalents during the first 24 hours after SG. 50 patients were needed to detect a 20% (0.4 mg) difference in the primary outcome. Secondary outcomes included postoperative pain scores.

Results: A total of 53 patients in the C group and 43 patients in APAP group were evaluated. No significant difference in opioid use was observed between the groups. Similarly, no difference in the pain score was observed. However, a significant time x gender x treatment interaction was observed, such that APAP treated men reported lower pain scores than control in the first 2 hours after surgery.

Conclusion: Although no significant group differences were observed for overall opioid use or pain scores in the first 24 hours after sleeve gastrectomy, secondary analyses suggesting that oral APAP may be more effective in men than women at early postoperative time points may warrant further controlled studies to confirm this finding.

Author(s): Emad Alsarraf*, Sarah Culbreth, Scott A Shikora, Darin J Correll, Kristin L Schreiber and Marjan Sadegh

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