Intravenous Acetaminophen in Orbital Surgery

Purpose: To assess the role of intravenous acetaminophen (IVA) in orbital surgery. Methods: Fifty control patients underwent orbital surgery without IVA. Fifty patients received 1 g of IVA within 30 minutes of surgery, and 50 patients received 1 g of IVA immediately preoperatively. Postoperative requirements for analgesic and antiemetic medications and standardized pain scores were recorded. Results: 44 patients (88%) in the control group and 57 patients (57%) that received IVA preoperatively required analgesic medications (p = 0.0023). 31 patients (62%) that received the medication within 30 minutes of surgery and 26 patients (52%) that received IVA immediately preoperatively required analgesic medications (p = 0.77). The control group had a greater requirement for analgesic medications than patients that received IVA within 30 minutes of orbital surgery (p = 0.0076) and those that received IVA immediately preoperatively (p = 0.032). Twelve patients in the control group (24%) and 4 patients (4%) in the group that received IVA preoperatively received anti-emetic medications (p = 0.0078). Mean pain scores for all patients that received IVA, patients that received IVA within 30 minutes of surgery, and patients that received IVA at the time of surgery were 3.68 (standard deviation = 3.24), 3.12 (standard deviation = 3.05) and 4.39 (standard deviation = 3.37), respectively, as compared to a mean control group score of 7.92 (standard deviation = 3.36), (p = 8.30x10(-15)). Conclusions: When administered prior to orbital surgery, IVA significantly reduced pain scores and postoperative requirements for analgesic and anti-nausea medications.