Intravenous Acetamenophen (Ofirmev) may Improve Post-surgical Pain Score in Periodontal and Oral Surgery Under General Anesthesia

Objectives: Post-surgical pain management is vital for the success of ambulatory office-based surgical procedures under general anesthesia. The objective of this study is to evaluate whether the addition of intravenous acetamenophen (Ofirmev) to a standard protocol of intravenous ketorolac, dexamethasone and intra-operative fentanyl with local anesthesia may improve the immediate post-operative pain score.
Methods: 24 adult patients ages 18 to 70 undergoing periodontal and oral surgery under general anesthesia are assigned randomly to one of two groups Group A receiving fentanyl 0.5 to 1 mcg/kg titrated intra-opertively as well as 8 mg of dexamethasone IV and 30 mg of ketorlac IV. Group B receive the same regimen in addition to 1 gram of IV acetaminophen infused over 15 minutes approximately 30 minutes prior to the end of surgery. Both groups are given propofol/sevoflurane general anesthesia and intra-oral local anesthesia with 2% lidocaine 1:100,000 epinephrine as well as 0.5% marcaine 1:200,000 epinephrine.
All patients are asked to assign a pain score dring recover 0=no to 10=worst pain ever experienced. Another pain score is requested of the patient the evening of surgery during a follow-up phone call.
Results: Early data suggests that the addition of intra-venous acetaminophen to a standard protocol of ketorolac, dexamethasone, fentanyl and local anesthesia can improve the pain score during the immediate post-operative period. More data is currently being collated.
Conclusions: Intravenous acetamenophen can improve post-surgical pain score when added to a stanard protocol of ketorolac, dexamethasone, fentanyl and local anesthesia. Larger double-blinded studies need to be conducted to confirm such findings