Around-the-clock acetaminophen after RARP effectively eases pain

Around-the-clock (ATC) administration of intravenous (IV) acetaminophen lowers postoperative pain and the need for emergency analgesia after robot-assisted radical prostatectomy (RARP), a recent study has shown.

Researchers conducted a retrospective observational study, enrolling 127 RARP patients who were given IV acetaminophen ATC, at fixed schedules. Postoperative pain intensity was measured using the numeric rating scale (NRS), and emergency analgesia was expressed as the number of additional analgesic doses needed. Assessments were done at postoperative days 0, 1, 2, 3, and 5. A comparator group of 485 patients given IV acetaminophen pro re nata (PRN) was also included.

Pain score was significantly lower in patients on ATC acetaminophen at postoperative days 1 (1.46±0.89 vs 2.08±1.09; p=0.001) and 2 (1.08±0.37 vs 1.49±0.89; p=0.001). The difference was nonsignificant both at day 0 and from day 3 and beyond

Similarly, the need for rescue analgesia was significantly lowered in the ATC vs PRN group at days 0 (0.50±0.60 vs 1.05±0.75; p=0.001), 1 (0.54±0.85 vs 1.65±1.10; p=0.001), and 2 (0.37±0.63 vs 0.67±0.81; p=0.001). The between-group discrepancy dropped to nonsignificant levels thereafter.

Researchers also assessed the patients’ catheter-related bladder discomfort (CRBD) and found that those given ATC acetaminophen had slightly but significantly lower scores at day 0 (0.88±0.80 vs 1.09±0.85; p=0.014). CRBD ratings were comparable between groups in the succeeding days.

“We feel this information will be valuable in counselling patients about their treatment options after diagnosis of localized prostate cancer, because the anxiety of potential pain associated with surgery is certainly a factor that weighs into a patient’s decision-making process,” the researchers said.

“Further research may be needed to determine if ATC administration benefits other populations following urologic surgery,” they added.