Pain management using acetaminophen throughout postoperative course of laparoscopic colorectal surgery: A case-matched control study

- Multimodal analgesia with acetaminophen was effective after laparoscopic surgery.
- Adverse events were less frequent with acetaminophen than epidural anesthesia.
- Frequency and variability of rescue use were lower with acetaminophen than epidural.

BackgroudThe main advantage of laparoscopic surgery is that it is minimally invasive because of the use of small incisions. An approach using small incisions offers many benefits including attenuation of surgical wound pain. However, the presence of postoperative pain may undermine the advantages of laparoscopic surgery as a minimally invasive technique. In addition, perioperative pain management is an important factor affecting recovery after surgery. This study investigated the usefulness of a multimodal approach to postoperative pain management with acetaminophen as a baseline analgesic after minimally invasive laparoscopic colorectal surgery.Materials and methodsThe study included 40 patients who underwent laparoscopic colorectal surgery for colorectal cancer. 20 patients received acetaminophen as a baseline analgesic for postoperative pain management and 20 received epidural anesthesia.ResultsThe urethral catheter could be removed earlier in the acetaminophen group (2.1 ± 0.22 days postoperatively) compared with the epidural group (4.1 ± 0.45days postoperatively). The frequencies of vertigo were significantly lower in the acetaminophen than epidural group (10.0% and 45.0%, respectively). The frequencies of the use of analgesics on an as-needed basis for postoperative pain relief as well as the variabilities in these frequencies, although not significantly different between the acetaminophen and epidural groups, were lower in the acetaminophen group than the epidural group.ConclusionWe herein demonstrated that postoperative pain management with acetaminophen as a baseline analgesic, and without the use of epidural anesthesia, is a safe and useful analgesic modality.