Can IV Acetaminophen Reduce Opioid Use after THA?

    A study underway at the Hospital for Special Surgery in New York is investigating whether intravenous (IV) acetaminophen could have a role in reducing the amount of opioid pain medicine needed after total hip arthroplasty.

    “We decided to undertake this study because research shows that acetaminophen in IV form reaches a higher peak concentration in the blood much faster than oral acetaminophen, and therefore crosses the blood-brain barrier much more quickly. The brain is the target organ where acetaminophen works to reduce pain,” said Geoffrey Westrich, MD, research director of the Adult Reconstruction and Joint Replacement Service at Hospital for Special Surgery.

    “We hypothesize that the intravenous form will be better at alleviating pain after hip replacement than the oral pill form.”

    Dr. Westrich and colleagues want to determine whether IV acetaminophen can provide sufficient pain relief to allow for a substantial reduction in opioid medication intake, leading to fewer side effects from the opioids. They also want to know if this approach will allow patients to achieve physical therapy goals more quickly.

     All patients will receive a standard pain control protocol. One group of patients will also receive IV acetaminophen and take an oral placebo pill. The other group will take oral acetaminophen and receive a placebo IV solution.

    In addition to determining whether IV acetaminophen leads to lower doses of opioid medication, the researchers will measure sedation effects, the achievement of physical therapy milestones, and length of hospital stay in patients given IV versus oral acetaminophen.

    “Because of its efficacy, general safety profile, and lower risk of adverse effects compared to other pain medications, intravenous acetaminophen could be an attractive component of the overall pain management plan,” Dr. Westrich said.

    “If we find that the IV form safely reduces the need for opioid medication, it would be advantageous for hip replacement patients.”

    More information on the study can be found here.