Pre-emptive paracetamol reduces intra-operative opioid use in patients undergoing day-case oncologic breast surgery.

Alsaadi, Daniah; Low, Lyndon; Ting, James; Craughwell, Michael; McDonnell, John; Lowery, Aoife; Sweeney, Karl

dc.contributor.author	Alsaadi, Daniah
dc.contributor.author	Low, Lyndon
dc.contributor.author	Ting, James
dc.contributor.author	Craughwell, Michael
dc.contributor.author	McDonnell, John
dc.contributor.author	Lowery, Aoife
dc.contributor.author	Sweeney, Karl
dc.date.accessioned	2024-11-26T14:59:52Z
dc.date.available	2024-11-26T14:59:52Z
dc.date.issued	2024-02-29
dc.identifier.issn	1611-2156
dc.identifier.pmid	38655093
dc.identifier.doi	10.17179/excli2023-6804
dc.identifier.uri	http://hdl.handle.net/10147/643442
dc.description	Minimization of intra-operative opioid use is an area of ongoing research interest with several potential benefits to the patient. Pre-emptive analgesia, defined as the administration of an analgesic before surgery to prevent establishment of central sensitization of pain, is one avenue that has been explored to achieve this. A retrospective observational study was undertaken to examine the effect of pre-emptive paracetamol on intra-operative opioid requirements. The medical and operative data of 156 patients who underwent day-case wide local excision and sentinel lymph node biopsy with and without regional block surgery at our center between October 2019 and May 2022 was carried out. Data were collected on demographics, total intra-operative and immediate post-operative opioid consumption. 57 patients did not receive pre-emptive paracetamol while 90 did. Baseline characteristics were similar. Our results showed a statistically significant reduction in morphine (p <0.029) and remifentanil (p <0.007) consumption in patients who received a regional block and pre-emptive paracetamol. Those who did not receive a regional block and were given pre-emptive paracetamol had a decrease in OxyNorm (p <0.022) requirements. A combination of general anesthesia (GA), regional block and pre-emptive paracetamol reduced intra-operative consumption of Fentanyl, OxyNorm, diclofenac, dexketoprofen, and clonidine (P <0.001) when compared to just GA alone. Use of pre-emptive paracetamol in reduction of intra-operative opioid requirements showed promising results but larger studies may strengthen the evidence for this association. A multimodal analgesic approach that utilizes pre-emptive paracetamol can be a viable method to decrease intra-operative of analgesic requirements.	en_US
dc.language.iso	en	en_US
dc.rights	Copyright © 2024 Alsaadi et al.
dc.rights	Attribution 4.0 International	*
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/	*
dc.subject	Breast surgery	en_US
dc.subject	intra-operative opioids	en_US
dc.subject	opioid-sparing	en_US
dc.subject	PAIN	en_US
dc.subject	pre-emptive analgesia	en_US
dc.title	Pre-emptive paracetamol reduces intra-operative opioid use in patients undergoing day-case oncologic breast surgery.	en_US
dc.type	Article	en_US
dc.identifier.journal	EXCLI journal	en_US
dc.source.journaltitle	EXCLI journal
dc.source.volume	23
dc.source.beginpage	356
dc.source.endpage	363
refterms.dateFOA	2024-11-26T14:59:54Z
dc.source.country	Germany