Preemptive Oral Acetaminophen for Women Undergoing Total Laparoscopic Hysterectomy.
Journal Article (Journal Article)
Objective
To decrease hospital expenses by administering oral acetaminophen rather than intravenous (IV) acetaminophen to women who undergo laparoscopic hysterectomy.Design
A quality improvement project using a between-groups, pre-/postimplementation design for women undergoing total laparoscopic hysterectomy. Retrospective chart review was used to compare data of women who received intraoperative IV acetaminophen before implementation versus women who received oral acetaminophen after implementation. Pain scores and opioid consumption in morphine equivalents were recorded at four time points.Setting/local problem
A 369-bed hospital in the southeastern United States, where, in 2016, nearly $260,000 was spent on perioperative IV acetaminophen for all operating room cases.Participants
Women between the ages of 18 and 55 years scheduled to have total laparoscopic hysterectomy were included. Excluded were women with a history of chronic pain, opioid use, or liver pathology; women with a contraindication to nonsteroidal anti-inflammatory drugs; and women whose procedures were converted from laparoscopic to open.Intervention/measurements
Women were instructed to take oral acetaminophen the day before surgery in divided doses, with 1 g every 6 hours, for a total dose of 3 g. On the day of surgery, women received the final 1-g dose of oral acetaminophen.Results
There were no significant differences between groups for pain scores or total opioids received before implementation (mean = 3.28, standard deviation = 2.05) compared with after implementation (mean = 3.65, standard deviation = 1.63; t [18] = -.043, p = .674). The preimplementation cost per individual was $30.03 for 1 g of IV acetaminophen, and the postimplementation cost was $0.36 for 2 500-mg oral acetaminophen tablets, a 98.8% relative cost decrease per woman.Conclusion
Replacing IV acetaminophen with preemptive oral acetaminophen has the potential to save money without compromising care.Full Text
Duke Authors
Cited Authors
- Atkins, JR; Titch, JF; Norcross, WP; Thompson, JA; Muckler, VC
Published Date
- April 2019
Published In
Volume / Issue
- 23 / 2
Start / End Page
- 105 - 113
PubMed ID
- 30826322
Electronic International Standard Serial Number (EISSN)
- 1751-486X
International Standard Serial Number (ISSN)
- 1751-4851
Digital Object Identifier (DOI)
- 10.1016/j.nwh.2019.01.003
Language
- eng