Effect of Acetaminophen on Postoperative Percocet Use In Hip Arthroscopy: A Randomized Controlled Trial.

Abstract

PURPOSE:

To determine whether postoperative acetaminophen reduced narcotic consumption following hip arthroscopy for femoroacetabular impingement.

METHODS:

This was a single-center randomized controlled trial. Opioid-naïve patients undergoing hip arthroscopy for femoroacetabular impingement were randomized into 2 groups. The control group received our institution's standard of care for postoperative pain control, 28 tablets of 5 mg/325 mg oxycodone-acetaminophen prescribed as 1 to 2 tablets every 6 hours as needed for pain, whereas the treatment group were prescribed 650 mg acetaminophen every 6 hours for pain, with 5 mg/325 mg oxycodone-acetaminophen prescribed for breakthrough pain. Patients were instructed to be mindful of taking no more than 3 g of acetaminophen in a 24-hour limit. If this limit was reached, oxycodone 5 mg would be prescribed. They were contacted daily and asked to report opioid use as well as their level of pain using the visual analog pain scale.

RESULTS:

Our institution enrolled 86 patients, 80 of whom completed the study (40 control, 40 treatment). There were no statistically significant differences with respect to patient demographics and patient-specific factors between groups (age at time of surgery, sex, American Society of Anesthesiologists classification, or body mass index). In addition, there was no statistically significant difference with respect to visual analog scale pain between groups preoperatively (P = .64) or at 1-week follow up (P = .39). The treatment group did not use a statistically significant different number of narcotics than the control group throughout the first postoperative week (6.325 pills treatment vs 5.688 pills control, P = .237).

CONCLUSIONS:

The findings of this randomized controlled trial suggest that postoperative acetaminophen may have no effect on reducing the number of narcotic pills consumed by opioid-naïve patients following hip arthroscopy in the setting of reduced opioid-prescribing on the part of orthopaedic surgeons. Furthermore, the results of this study suggest surgeons may reduce postoperative narcotic prescribing without reducing patient satisfaction following hip arthroscopy.

LEVEL OF EVIDENCE:

II randomized control trial.

• Authors: David A Bloom, David J Kirby, Kamali Thompson, Samuel L Baron, Crist Chee, Thomas Youm
• Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) Vol. 37 Issue 2 Pg. 530-536 (02 2021) ISSN: 1526-3231 [Electronic] United States
• PMID: 33045334 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2020 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Chemical References

• Analgesics, Opioid
• Acetaminophen
• Oxycodone

Topics

• Acetaminophen (therapeutic use)
• Adult
• Analgesics, Opioid (therapeutic use)
• Arthroscopy
• Female
• Femoracetabular Impingement (surgery)
• Hip (surgery)
• Humans
• Male
• Middle Aged
• Oxycodone (therapeutic use)
• Pain Measurement
• Pain, Postoperative (drug therapy)
• Patient Satisfaction
• Prospective Studies