Objective

To compare the effect of preoperative intravenous (IV) acetaminophen versus oral (PO) acetaminophen or placebo on postoperative pain scores and the time to discharge in women undergoing oocyte retrieval.

Design

Randomized, double-blind, placebo-controlled trial.

Setting

Single academic fertility center.

Patient(s)

Women aged 18–43 years undergoing oocyte retrieval.

Intervention(s)

Randomization to preoperative 1,000 mg IV acetaminophen and PO placebo (group A), IV placebo and 1,000 mg PO acetaminophen (group B), or IV and PO placebo (group C)

Main Outcome Measure(s)

Difference in patient-reported postoperative visual analog scale pain scores from baseline and the time to discharge.

Result(s)

Of the 159 women who completed the study, there were no differences in the mean postoperative pain score differences or the time to discharge. Although not statistically significant, the mean postoperative opioid dose requirement in group A was lower than that in groups B and C (0.24 vs. 0.59 vs. 0.58 mg IV morphine equivalents, respectively) due to fewer women in group A requiring rescue pain medication (8% vs. 19% vs. 15%, respectively). Group A also reported less constipation when compared with groups B and C (19% vs. 33% vs. 40%, respectively). The rates of postoperative nausea were similar, and there were no differences in embryology or early pregnancy outcomes between the study groups.

Conclusion(s)

Preoperative IV acetaminophen for women undergoing oocyte retrieval did not reduce postoperative pain scores or shorten the time to discharge when compared with PO acetaminophen or placebo and, thus, cannot currently be recommended routinely in this patient population.

Clinical Trial Registration Number

NCT03073980.

中文翻译：

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评估静脉注射对乙酰氨基酚对取卵术围手术期疼痛控制的疗效：一项随机、双盲、安慰剂对照试验

客观的

比较术前静脉注射 (IV) 对乙酰氨基酚与口服 (PO) 对乙酰氨基酚或安慰剂对取卵妇女术后疼痛评分和出院时间的影响。

设计

随机、双盲、安慰剂对照试验。

环境

单一学术生育中心。

耐心）

接受卵母细胞取出的 18-43 岁女性。

干预措施

随机分配至术前 1,000 mg IV 对乙酰氨基酚和 PO 安慰剂（A 组）、IV 安慰剂和 1,000 mg PO 对乙酰氨基酚（B 组）或 IV 和 PO 安慰剂（C 组）

主要观察指标）

患者报告的术后视觉模拟量表疼痛评分与基线和出院时间的差异。

结果）

在完成研究的 159 名女性中，术后平均疼痛评分差异或出院时间没有差异。虽然没有统计学意义，但 A 组术后阿片类药物的平均剂量要求低于 B 组和 C 组（分别为 0.24 对 0.59 对 0.58 毫克吗啡当量静脉注射），因为 A 组中需要止痛药的女性较少（ 8% 对 19% 对 15%，分别）。与 B 组和 C 组相比，A 组的便秘也较少（分别为 19% 对 33% 对 40%）。术后恶心的发生率相似，研究组之间的胚胎学或早孕结局没有差异。

结论

与口服对乙酰氨基酚或安慰剂相比，对接受取卵的女性进行术前静脉注射对乙酰氨基酚并未降低术后疼痛评分或缩短出院时间，因此目前不能在该患者人群中常规推荐。

临床试验注册号

NCT03073980。