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IV or Oral Acetaminophen for THA? New Data From HSS

Orthopedics This Week reports on study findings published in The Journal of Arthroplasty by HSS researchers which examined the differences in managing pain between oral and intravenous acetaminophen following a total hip arthroplasty, and found there is no difference in opioid side effects, pain scores, or opioid use.

Co-author Geoffrey H. Westrich, MD, hip surgeon at HSS provided further commentary on the outcome, and cited, "Our results demonstrated that there was no difference in Opioid Related Symptom Distress Scale scores, numerical rating pain scores with physical therapy, or mean oral morphine equivalents between the two groups." Additionally, Dr. Westrich noted, "Secondary outcomes, including time to discharge, other descriptions of pain outcomes, satisfaction, and cognitive effects were not different between groups. Patient satisfaction was graded on a numerical rating scale from 1 to 10 (with 10 being the most satisfied) and both groups had a rating of 9 out of 10 indicating excellent patient satisfaction with our low opioid multimodal pain management protocol with oral and intravenous acetaminophen."

With regard to the challenges facing multimodal anesthesia, Dr. Westrich said, "It is really the variability in patients’ response to pain management. Some patients need no narcotics, some standard strength narcotics, and some more potent narcotics and we never know until after surgery. We just need to have a solid protocol and be prepared. Having said that, the utilization of a multimodal protocol, in general, requires less narcotics and attacks the pain pathways from different angles."

Read the full article at ryortho.com.