Additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trial

Abstract Background Acetaminophen is a widely used analgesic for postoperative pain management. However, data on its combined use with nefopam for managing postoperative pain following laparoscopic hysterectomy are limited. This study evaluated the effects of a single intravenous dose of acetaminoph...

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Main Authors: Seungpyo Nam, Seokha Yoo, Sun-Kyung Park, Jin-Tae Kim
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-02971-w
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author Seungpyo Nam
Seokha Yoo
Sun-Kyung Park
Jin-Tae Kim
author_facet Seungpyo Nam
Seokha Yoo
Sun-Kyung Park
Jin-Tae Kim
author_sort Seungpyo Nam
collection DOAJ
description Abstract Background Acetaminophen is a widely used analgesic for postoperative pain management. However, data on its combined use with nefopam for managing postoperative pain following laparoscopic hysterectomy are limited. This study evaluated the effects of a single intravenous dose of acetaminophen combined with fentanyl- and nefopam-based patient-controlled analgesia (PCA) in patients undergoing laparoscopic hysterectomy. Methods In this prospective, double-blind, randomized controlled trial, 84 patients were randomized to receive either 1 g of intravenous acetaminophen (treatment group, n = 42) or normal saline (control group, n = 42) at the end of surgery. All patients received fentanyl and nefopam via PCA, postoperatively. PCA consumption, pain scores at rest, and postoperative nausea and vomiting (PONV) scores were assessed at 1, 6, and 24 h postoperatively. Patient satisfaction and opioid-related side effects were also evaluated. The primary outcome was the total PCA consumption within the first 24 h. Results No significant difference in 24-h PCA consumption was observed between the control and treatment groups (27.9 ± 16.6 vs. 26.4 ± 11.2, P = 0.623). The pain scores at rest measured at 1, 6, and 24 h after surgery were also not significantly different between the two groups. There were no differences in the satisfaction scores, PONV scores, rescue analgesic use, adverse effects, or length of hospital stay between the groups. Conclusions A single intraoperative dose of intravenous acetaminophen, combined with nefopam- and fentanyl-based PCA, did not significantly reduce analgesic requirements, pain scores at rest, or opioid-related side effects compared with placebo in laparoscopic hysterectomy patients. Trial registration ClinicalTrials.gov (Identifier: NCT03644147 | August 21, 2018).
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spelling doaj-art-40f7e77dbd7f4e61ab96b2bb9af5c96e2025-08-20T03:10:56ZengBMCBMC Anesthesiology1471-22532025-02-012511810.1186/s12871-025-02971-wAdditive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trialSeungpyo Nam0Seokha Yoo1Sun-Kyung Park2Jin-Tae Kim3Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of MedicineDepartment of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of MedicineDepartment of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of MedicineDepartment of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of MedicineAbstract Background Acetaminophen is a widely used analgesic for postoperative pain management. However, data on its combined use with nefopam for managing postoperative pain following laparoscopic hysterectomy are limited. This study evaluated the effects of a single intravenous dose of acetaminophen combined with fentanyl- and nefopam-based patient-controlled analgesia (PCA) in patients undergoing laparoscopic hysterectomy. Methods In this prospective, double-blind, randomized controlled trial, 84 patients were randomized to receive either 1 g of intravenous acetaminophen (treatment group, n = 42) or normal saline (control group, n = 42) at the end of surgery. All patients received fentanyl and nefopam via PCA, postoperatively. PCA consumption, pain scores at rest, and postoperative nausea and vomiting (PONV) scores were assessed at 1, 6, and 24 h postoperatively. Patient satisfaction and opioid-related side effects were also evaluated. The primary outcome was the total PCA consumption within the first 24 h. Results No significant difference in 24-h PCA consumption was observed between the control and treatment groups (27.9 ± 16.6 vs. 26.4 ± 11.2, P = 0.623). The pain scores at rest measured at 1, 6, and 24 h after surgery were also not significantly different between the two groups. There were no differences in the satisfaction scores, PONV scores, rescue analgesic use, adverse effects, or length of hospital stay between the groups. Conclusions A single intraoperative dose of intravenous acetaminophen, combined with nefopam- and fentanyl-based PCA, did not significantly reduce analgesic requirements, pain scores at rest, or opioid-related side effects compared with placebo in laparoscopic hysterectomy patients. Trial registration ClinicalTrials.gov (Identifier: NCT03644147 | August 21, 2018).https://doi.org/10.1186/s12871-025-02971-wAcetaminophenFentanylNefopamPostoperative pain controlPatient-controlled analgesia
spellingShingle Seungpyo Nam
Seokha Yoo
Sun-Kyung Park
Jin-Tae Kim
Additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trial
BMC Anesthesiology
Acetaminophen
Fentanyl
Nefopam
Postoperative pain control
Patient-controlled analgesia
title Additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trial
title_full Additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trial
title_fullStr Additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trial
title_full_unstemmed Additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trial
title_short Additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl-based patient-controlled analgesia: a double-blind, randomized controlled trial
title_sort additive effect of a single intravenous dose of acetaminophen administered at the end of laparoscopic hysterectomy on postoperative pain control with nefopam and fentanyl based patient controlled analgesia a double blind randomized controlled trial
topic Acetaminophen
Fentanyl
Nefopam
Postoperative pain control
Patient-controlled analgesia
url https://doi.org/10.1186/s12871-025-02971-w
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