Efficacy of intravenous acetaminophen as adjunct analgesia in patients undergoing cardiovascular surgery: a systematic review and meta-analysis.

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Korean Journal of Pain Pub Date : 2025-07-01 Epub Date: 2025-06-25 DOI:10.3344/kjp.25063

Soowon Lee, Chang-Hoon Koo, Yu Kyung Bae, Jung-Hee Ryu

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引用次数: 0

Abstract

Background: Although intravenous (IV) acetaminophen (AAP) may help reduce severe postoperative pain and opioid use after cardiovascular surgery, its effectiveness must be further validated. Therefore, the authors aimed to evaluate the analgesic efficacy of perioperative IV AAP in patients undergoing cardiovascular surgery by conducting this meta-analysis.

Methods: A comprehensive literature search was conducted of PubMed, Embase, CENTRAL, CINAHL, Scopus, and Web of Science databases for studies published up to March 21, 2024. Six randomized controlled trials comparing IV AAP with a placebo in cardiovascular surgery were included. The mean difference (MD) was calculated to estimate pooled effect sizes. The primary outcome was opioid consumption, measured in morphine equivalent dose, and the secondary outcome was postoperative pain score.

Results: Postoperative opioid consumption was significantly reduced with IV AAP than it was with a placebo (MD: -21.68, 95% confidence interval [CI]: -38.41 to -4.95, P = 0.011). Significant reductions in postoperative pain scores were observed at 6 hours (MD: -0.76, 95% CI: -1.43 to -0.10, P = 0.025) and 24 hours (MD: -0.63, 95% CI: -1.02 to -0.25, P = 0.001) after surgery. However, these reductions did not meet clinically meaningful thresholds. No significant differences were observed at 12, 18, and 48 hours postoperatively.

Conclusions: IV AAP was more effective than a placebo for postoperative adjunct analgesia in patients who underwent cardiovascular surgery.

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静脉对乙酰氨基酚作为心血管手术患者辅助镇痛的疗效：一项系统综述和荟萃分析。

背景：虽然静脉注射（IV）对乙酰氨基酚（AAP）可能有助于减少心血管手术后严重的术后疼痛和阿片类药物的使用，但其有效性必须进一步验证。因此，作者旨在通过本荟萃分析，评估心血管手术患者围手术期静脉注射AAP的镇痛效果。方法：综合检索PubMed、Embase、CENTRAL、CINAHL、Scopus和Web of Science数据库，检索截止到2024年3月21日发表的研究。6个随机对照试验比较静脉注射AAP和安慰剂在心血管手术中的应用。计算平均差异（MD）来估计合并效应大小。主要结局是阿片类药物消耗，以吗啡当量剂量衡量，次要结局是术后疼痛评分。结果：与安慰剂组相比，静脉注射AAP组术后阿片类药物消耗显著减少（MD: -21.68, 95%可信区间[CI]: -38.41 ~ -4.95, P = 0.011）。术后疼痛评分在术后6小时（MD: -0.76, 95% CI: -1.43至-0.10,P = 0.025）和24小时（MD: -0.63, 95% CI: -1.02至-0.25,P = 0.001）显著降低。然而，这些减少没有达到有临床意义的阈值。术后12、18、48小时无明显差异。结论：在心血管手术患者的术后辅助镇痛中，静脉注射AAP比安慰剂更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Korean Journal of Pain Medicine-Anesthesiology and Pain Medicine

CiteScore

5.40

自引率

7.10%

发文量

审稿时长

16 weeks

期刊介绍： Korean Journal of Pain (Korean J Pain, KJP) is the official journal of the Korean Pain Society, founded in 1986. It has been published since 1988. It publishes peer reviewed original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. It has been published quarterly in English since 2009 (on the first day of January, April, July, and October). In addition, it has also become the official journal of the International Spinal Pain Society since 2016. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals. The circulation number per issue is 50.