result, 22 study comparisons were
analyzed: IV acetaminophen to an active comparator (n = 8
studies) and IV acetaminophen to placebo (n = 14 studies).
The RCTs were of high methodological quality with Jadad
median score = 5. In 7 of 8 active comparator studies (IV
parecoxib [n = 3 studies], IV metamizol [n = 4], oral ibuprofen
[n = 1]), IV acetaminophen had similar analgesic outcomes as
the active comparator. Twelve of the 14 placebo studies
found that IV acetaminophen patients had improved analgesia.
Ten of those 14 studies reported less opioid consumption,
a lower percentage of patients rescuing, or a longer
time to first rescue with IV acetaminophen. Formal metaanalysis
pooling was not performed because the studies had
different primary end points, and the IV acetaminophen
dosing regimens varied in dose, and duration and timing.
Conclusion: In aggregate, these data indicate that IV
acetaminophen is an effective analgesic across a variety of
surgical procedures