IV Acetaminophen for Post-Operative Pain Management in Enhanced Recovery After Surgery (ERAS) Population
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ClinicalTrials.gov Identifier: NCT03198871 |
Recruitment Status :
Active, not recruiting
First Posted : June 26, 2017
Last Update Posted : October 3, 2019
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Condition or disease | Intervention/treatment | Phase |
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Abdominal Wall Hernia Pancreatic Diseases Bowel Disease Gastric Disease | Drug: Acetaminophen Injectable Product Drug: Sodium Chloride 0.9%, Intravenous | Phase 4 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 180 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
Masking Description: | Participant, care provider, outcomes assessor and investigator are all blinded to the treatment allocation |
Primary Purpose: | Treatment |
Official Title: | Role of Scheduled Intravenous Acetaminophen for Postoperative Pain Management in an Enhanced Recovery After Surgery (ERAS) Population: A Prospective, Randomized, Double-Blind and Placebo-Controlled Clinical Trial |
Actual Study Start Date : | May 24, 2018 |
Actual Primary Completion Date : | July 7, 2019 |
Estimated Study Completion Date : | December 20, 2019 |

Arm | Intervention/treatment |
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Experimental: Acetaminophen Injectable Product
Acetaminophen group: Half of subjects enrolled will be randomized to the acetaminophen group
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Drug: Acetaminophen Injectable Product
The interventional group will receive 1 gram intravenous acetaminophen at the start of wound closure to be repeated every 6 hours for 48 hours postoperatively
Other Names:
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Placebo Comparator: Sodium Chloride 0.9%, Intravenous
Sodium Chloride 0.9% group: Half of subjects enrolled will be randomized to the acetaminophen group
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Drug: Sodium Chloride 0.9%, Intravenous
The placebo group will be given an intravenous placebo of saline solution at wound closure and repeated every 6 hours for 48 hours postoperatively.
Other Name: Saline |
- Postoperative Pain Intensity [ Time Frame: PACU admission every thirty minutes until discharge to the floor and thereafter every four hours for first 24-hour, then every six hours until 48 hours and then every twelve hours until 72 hours postoperatively. ]Number of patients with unsatisfactory pain relief defined as average numeric rating scale (NRS) more than 5 will be compared between the two groups. This may include patients using IVPCA for pain relief during the first 48 hours postoperative.
- Total post-operative narcotic consumption [ Time Frame: From time of PACU admission until the time of discharge and 72-hours postoperatively, whichever comes first ]Rescue analgesia will be given according to institutional pain management protocol
- Time to readiness for discharge from post anesthesia care unit (PACU) [ Time Frame: From time of PACU admission until the time of discharge, assessed up to 24 hours postoperatively ]The time from PACU admission to PACU discharge to the floor will be measured.
- Time to bowel movement [ Time Frame: From date of randomization until the date of first documented bowel movement, assessed up 72 hour postoperatively ]The time it takes for the first bowel movement postoperatively will be measured.
- Time to oral intake [ Time Frame: From date of randomization until the date of first documented oral intake, assessed up to 72 hours postoperatively ]The time it takes for the patient to ingest orally post-surgery will be measured.
- Time to ambulation [ Time Frame: From date of PACU admission until the date of first documented ambulation, assessed up to 72 hours postoperatively ]The time it takes for the patient to successfully ambulate post-surgery will be measured.
- Time to hospital discharge [ Time Frame: From date of randomization until the date of hospital discharge or 30 days postoperatively, whichever comes first ]The time it takes for the patient to be fully discharged from the hospital post-surgery will be measured.
- Readmission to the hospital [ Time Frame: From the time of consent until 30 days post-operatively ]If the patient is readmitted to the hospital after being fully discharged, the even will be recorded.
- Patient Satisfaction [ Time Frame: These measurements will be taken at time of discharge up to 30 days, whichever comes first ]Overall patient satisfaction as well as satisfaction relating to pain management and cost analyses will be measured. These will be measured with a numerical rating scale with 0- being worst satisfaction and 10 - best satisfaction.
- Intensive Care Delirium Screening Checklist (ICDSC) [ Time Frame: The delirium scores will first be measured every 12 hours for 72 hours after surgery. ]The ICDSC will be used to assess delirium scores.
- Post-operative Nausea [ Time Frame: These will be evaluated from the time of PACU admission until 72 hours postoperatively. ]Nausea will be evaluated by nausea score (0-10)
- Post-operative Emesis [ Time Frame: These will be evaluated from the time of PACU admission until 72 hours postoperatively. ]Frequency of emesis and rescue antiemetic requirement will be documented
- SF-12 health survey [ Time Frame: These measurements will take place at 30-days post hospital discharge ]Survey to assess patient's overall health at 30 days post-discharge

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Male or Female
- 18 years of age or older
- patients scheduled for elective colorectal, pancreatic, and other major abdominal procedure.
- Patient consent will be obtained preoperatively for eligible study participants.
Exclusion Criteria:
- Patients who refuse to participate in the study or part of any other enhanced recovery after surgery (ERAS) research protocol.
- Patients with a documented allergy to acetaminophen.
- Chronic alcoholism
- Hypovolemia
- Chronic malnutrition
- Preoperative renal insufficiency (creatinine clearance less than or equal to 30ml/min) or hemodialysis
- Patients with a history of hepatic impairment, history of hepatic impairment or active hepatic disease
- severe chronic pain condition that required daily preoperative opioid dependence
- Patients with pre-existing dementia and/or other neuropsychiatric conditions impeding accurate assessment of pain scores or other study measures will be excluded.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03198871
United States, Pennsylvania | |
Upmc Presbyterian Montefiore Hospital | |
Pittsburgh, Pennsylvania, United States, 15213 |
Principal Investigator: | Kathirvel Subramaniam, M.D., M.P.H | Associate Professor and staff Anesthesiologist |
Publications:
Responsible Party: | Kathirvel Subramaniam, Principal Investigator, Associate Professor, University of Pittsburgh |
ClinicalTrials.gov Identifier: | NCT03198871 History of Changes |
Other Study ID Numbers: |
PRO17050418 |
First Posted: | June 26, 2017 Key Record Dates |
Last Update Posted: | October 3, 2019 |
Last Verified: | October 2019 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | Yes |
Post-operative pain Major abdominal surgery Colorectal surgery Gastric surgery |
Pancreatic Diseases Stomach Diseases Hernia, Ventral Hernia Pathological Conditions, Anatomical Gastrointestinal Diseases Digestive System Diseases Hernia, Abdominal |
Acetaminophen Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Antipyretics |