Continuous Multimechanistic Postoperative Analgesia: A Rationale for Transitioning from Intravenous Acetaminophen and Opioids to Oral Formulations

Pain Practice

Volumn 12, Issue 2, 2012, Pages 159-173

  Pergolizzi, Joseph V ^a,b,c   Raffa, Robert B ^d   Tallarida, Ronald ^e   Taylor, Robert ^c   Labhsetwar, Sumedha A ^c  

^a JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c NEMA Research   (United States)

^d TEMPLE UNIVERSITY SCHOOL OF PHARMACY   (United States)

^e TEMPLE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Acetaminophen; Intravenous acetaminophen; Intravenous paracetamol; Paracetamol; Postsurgical pain management

Indexed keywords

ACETYLSALICYLIC ACID; CELECOXIB; CODEINE; DEXAMETHASONE; DEXTROPROPOXYPHENE; DICLOFENAC; DIPYRONE; HYDROCODONE BITARTRATE PLUS PARACETAMOL; IBUPROFEN; KETOPROFEN; MELOXICAM; MORPHINE; NAPROXEN; NIMESULIDE; OPIATE; OXYCODONE; PARACETAMOL; PARACETAMOL PLUS TRAMADOL; PARECOXIB; PERCOCET; PETHIDINE; PIROXICAM; PROPACETAMOL; ROFECOXIB; TRAMADOL; VALDECOXIB;

ABDOMINAL HYSTERECTOMY; BRAIN REGION; BREAST SURGERY; CHOLECYSTECTOMY; CONSTIPATION; CORONARY ARTERY BYPASS GRAFT; CURETTAGE; DIZZINESS; DROWSINESS; DRUG DOSE INCREASE; DRUG DOSE TITRATION; DRUG EFFICACY; DRUG ERUPTION; DRUG FORMULATION; DRUG INDUCED HEADACHE; DRUG MECHANISM; DRUG METABOLISM; DRUG SAFETY; DRUG TOLERABILITY; HUMAN; HYPOTENSION; INTERVERTEBRAL DISKECTOMY; LAMINECTOMY; LOW DRUG DOSE; MAXIMUM PLASMA CONCENTRATION; META ANALYSIS (TOPIC); MONOTHERAPY; NAUSEA; NAUSEA AND VOMITING; ORAL SURGERY; PATIENT SATISFACTION; POSTANESTHESIA CARE; POSTOPERATIVE ANALGESIA; POSTOPERATIVE NAUSEA AND VOMITING; POSTOPERATIVE PAIN; POSTOPERATIVE VOMITING; PROTEIN EXPRESSION; RANDOMIZED CONTROLLED TRIAL (TOPIC); RESPIRATION DEPRESSION; REVIEW; SOMNOLENCE; SPINE FUSION; TONSILLECTOMY; TREATMENT OUTCOME; UNSPECIFIED SIDE EFFECT; URINE RETENTION; VISUAL ANALOG SCALE; VOMITING;

EID: 84856571039     PISSN: 15307085     EISSN: 15332500     Source Type: Journal    
DOI: 10.1111/j.1533-2500.2011.00476.x     Document Type: Review

References (134)

1. CDC. Press release. 2009; Available at: Accessed October 18, 2010.
2. Roan S. Anesthesia's effect may linger after patient goes home. 2005; Available at: Accessed October 18, 2010.
3. Warfield C, Kahn C. Acute pain management: programs in US hospitals and experiences and attitudes among US adults. Anesthesiology. 1995;49:755-758.
4. Shang A, Gan T. Optimising postoperative pain management in the ambulatory setting. Drugs. 2003;63:855-867.
5. WHO. WHO's pain ladder. 1986; Available at: Accessed October 18, 2010.
6. Raffa R, Pergolizzi J, Tallarida R. The determination and application of fixed-dose analgesic combinations for treating multimodal pain. J Pain. 2010;11:701-709.
7. Woolf C. Moving from symptom control toward mechanism-specific pharmacological management. Ann Int Med. 2004;140:441-451.
8. White P. Multimodal analgesia: its role in preventing postoperative pain. Curr Opin Investig Drugs. 2008;9:76-82.
9. Woolf C. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152:S2-S15.
10. Burstein R, Jakubowski M. Implications of multimechanism therapy: when to treat? Neurology. 2005;64(suppl 2):S16-S20.
11. Yaster M. Multimodal analgesia in children. Eur J Anaesthesiol. 2010;27:851-857.
12. Fu P, Xiao J, Zhu Y, et al. Efficacy of a multimodal analgesia protocol in total knee arthroplasty: a randomized, controlled trial. J Int Med Res. 2010;38:1404-1412.
13. Cho C-H, Song K-S, Min B-W, et al. Multimodal approach to postoperative pain control in patients undergoing rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 2010;[Epub ahead of print].
14. Koh I, Kang Y, Chang C, et al. Additional pain relieving effect of intraoperative periarticular injections after simultaneous bilateral TKA: a randomized, controlled study. Knee Surg Sports Traumatol Arthrosc. 2010;18:916-922.
15. Hebl J, Dilger J, Byer D, et al. A pre-emptive multimodal pathway featuring peripheral nerve block improves periopertive outcomes after major orthopedic surgery. Reg Anesth Pain Med. 2008;33:510-517.
16. Jin F, Chung F. Multimodal analgesia for postoperative pain control. J Clin Anesth. 2001;13:524-539.
17. Gever J. IV acetaminophen wins approval. Medpage Today 2010; Available at: Accessed November 8, 2010.
18. Duggan S, Scott L. Intravenous paracetamol (acetaminophen). Drugs. 2009;69:101-113.
19. Schmitt E, Vainchtock A, Nicoloyannis N, Locher F, Mesrobian X. Ready to use injectable paracetamol: easier, safer, lowering workload and costs. Eur Assoc Hosp Pharmacists. 2003;6:96-102.
20. Bertolini A, Ferrari A, Ottani A, Guerzoni S, Tacchi R, Leone S. Paracetamol: new vistas of an old drug. CNS Drug Rev. 2006;12:250-275.
21. Acetaminophen overdose. Medline Plus 2009; Available at: Accessed August 13, 2010.
22. Weil K, Hooper L, Afzal Z, et al. Paracetamol for pain relief after surgical removal of lower wisdom teeth (review). Cochrane Database Syst Rev. 2007;3:CD004487.
23. Moller P, Sindet-Pedersen S, Petersen C, Juhl G, Dillenschneider A, Skoglund L. Onset of acetamiophen analgesia: comparison of oral and intravenous routes after third molar surgery. Br J Anaesth. 2005;94:642-648.
24. Hendrickson R, Bizovi K, eds. Acetaminophen. New York: McGraw-Hill; 2006. Nelson L, Flomenbaum N, Goldfrank L, eds. Goldfrank's Toxicologic Emergencies.
25. Dong H, Haining R, Thummel K, Rettie A, Nelson S. Involvement of human cytochrome P450 2D6 in the bioactivation of acetaminophen. Drug Metab Disp. 2000;28:1397-1400.
26. Bonnefont J, Courade J, Alloui A, Eschalier A Antinociceptive mechanism of action of paracetamol. Drugs. 2003;63(No. 2):1-4.
27. Vane J. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol. 1971;231:232-235.
28. Graham G, Scott K. Mechanism of action of paracetamol. Am J Ther. 2005;12:46-55.
29. Aronoff D, Oates J, Boutaud O. New insights into the mechanism of action of acetaminophen: its clinical pharmacological characteristics reflect its inhibition of the two prostaglandin H2 synthases. Clin Pharmacol Ther. 2006;79:9-19.
30. Flower R, Vane J. Inhibition of prostaglandin synthetase in brain explains the anti-pyretic activity of paracetamol (4-acetamidophenol). Nature. 1972;240:410-411.
31. Ouellet M, Percival M. Mechanism of acetaminophen inhibition of cyclooxygenase isoforms. Arch Biochem Biphys. 2001;387:273-280.
32. Botting R. COX-1 and COX-3 inhibitors. Thrombosis Res. 2003;110:269-272.
33. Graham G, Scott K. Mechanisms of action of paracetamol and related analgesics. Inflammopharmacology. 2003;11:401-413.
34. Davies N, Good R, Roupe K, Yanez J. Cyclooxygenase-3: axiom, dogma, anomaly, enigma or splice error? Not as easy as 1, 2, 3. J Pharm Pharmaceut Sci. 2004;7:217-226.
35. Kis B, Snipes J, Busija D. Acetaminophen and the cyclooxygenase-3 puzzle: sorting out facts, fictions, and uncertainties. J Pharm Exp Ther. 2005;315:1-7.
36. Hinz B, Cheremina O, Brune K. Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor. FASEB J. 2008;22:383-390.
37. Lucas R, Warner T, Vojnovic I, Mitchell J. Cellular mechanisms of acetaminophen: role of cyclo-oxygenase. FASEB J. 2005;19:635-637.
38. Berenbaum F. COX-3: fact or fancy? Joint Bone Spine. 2004;71:451-453.
39. Botting R, Ayoub S. COX-3 and the mechanism of action of paracetamol/acetaminophen. Prostaglandins Leukot Essent Fatty Acids. 2005;72:85-87.
40. Bonnefont J, Daulhac L, Etienne M, et al. Acetaminophen recruits spinal p42/p44 MAPKs and GH/IGF-1 receptors to produce analgesia via the serotonergic system. Mol Pharmacol. 2007;71:407-415.
41. Pickering G, Loriot M, Libert F, Eschalier A, Beaune P, Dubray C. Analgesic effect of acetaminophen in humans: first evidence of a central serotonergic mechanism. Clin Pharmacol Ther. 2006;79:371-378.
42. Tjolsen A, Lund A, Hole K. Antinociceptive effect of paracetamol in rats is partly depend on spinal serotonergic systems. Eur J Pharmacol. 1991;193:193-201.
43. Pini L, Sandrini M, Vitale G. The antinociceptive action of paracetamol is associated with changes in the serotonergic system in the rat brain. Eur J Pharmacol. 1996;308:31-40.
44. Russo R, Loverne J, LaRana G, et al. The fatty acid amide hydrolase inhibitor URB597 (cyclohexylcarbamic acid 3′-carbamoylbiphenyl-3-yl-ester) reduces neuropathic pain after oral administration in mice. J Pharm Exp Ther. 2007;322:236-242.
45. Ottani A, Leone S, Sandrini M, Ferrari A, Bertolini A. The analgesic activity of paracetamol is prevented by the blockade of cannabinoid CB1 receptors. Eur J Pharmacol. 2006;531:280-281.
46. Hogestatt E, Jonsson B, Ermund A. Conversion of acetaminophen to the bioactive N-acylphenolamine AM404 via fatty acid amide hydrolase-dependent arachidonic acid conjugation in the nervous system. J Biol Chem. 2005;280:31405-31412.
47. Zygmunt P, Chuang H, Movahed P, Julius D, Hogestatt E. The anandamide transport inhibitor AM404 activates vanilloid receptors. Eur J Pharmacol. 2000;396:39-42.
48. Bjorkman R, Hallman K, Hedner J, Hedner T, Henning M. Acetaminophen blocks spinal hyperalgesia induced by NMDA and substance P. Pain. 1994;57:259-264.
49. Bujalska M. Effect of nitric oxide synthase inhibition on antinociceptive action of different doses of acetaminophen. Pol J Pharmacol. 2004;56:605-610.
50. Raffa R. Acetaminophen and metabolite: lack of effect on nitric oxide synthase (constitutive or inducible). Headache. 2002;42:237-238.
51. Anderson B. Paracetamol (acetaminophen): mechanisms of action. Paediatr Anaesth. 2008;18:915-921.
52. Bisogno T. Endogenous cannabinoids: structure and metabolism. J Neuroendocrinol. 2008;20(suppl 1):1-9.
53. Raffa R, DJ Stone J, Tallardia R. Discovery of "self-synergistic" spinal/supraspinal antinociception produced by acetaminophen (paracetamol). J Pharmacol Exp Ther. 2000;295:291-294.
54. Raffa R, Walker E, Sterious S. Opioid receptors and acetaminophen (paracetamol). Eur J Pharmacol. 2004;503:209-210.
55. Mom T, Bazin J, Commun F, et al. Assessment of postoperative pain after laryngeal surgery for cancer. Arch Otolaryngol Head Neck Surg. 1998;124:794-798.
56. Fletcher D, Negre I, Barbin C, et al. Postoperative analgesia with i.v. propacetamol and ketoprofen combination after disc surgery. Can J Anesth. 1997;44(5 Pt 1):479-485.
57. Hernandez-Palazon J, Tortosa J, Martinez-Lage J, Perez-Flores D. Intravenous administration of propacetamol reduces morphine consumption after spinal fusion surgery. Anesth Analg. 2001;92:1473-1476.
58. Api O, Unal O, Ugurel V, Emeksiz M, Turan C. Analgesic efficacy of intravenous paracetamol for outpatient fractional curettage: a randomised controlled trial. Int J Clin Pract. 2009;63:105-111.
59. Hein A, Jakobsson J, Ryberg G. Paracetamol 1g given rectally at the end of minor gnyaecological surgery is not efficacious in reducing postoperative pain. Acta Anaesthesiol Scand. 1999;43:248-251.
60. Dahl V, Fjellanger F, Raeder J. No effect of preoperative paracetamol and codeine suppositories for pain after termination of pregnancies in general anesthesia. Eur J Pain. 2000;4:211-215.
61. Edwards J, McQuay H, Moore R. Combination analgesic efficacy: individual patient data meta-analysis of single-dose oral tramadol plus acetaminophen in acute postoperative pain. J Pain Symptom Manage. 2002;18:427-437.
62. Kehlet H, Wilmore D. Multimodal strategies to improve surgical outcome. Am J Surg. 2002;183:630-641.
63. Elvir-Lazo O, White P. Postoperative pain management after ambulatory surgery: role of multimodal analgesia. Anesthesiol Clin. 2010;28:217-224.
64. Raffa R, Pergolizzi J, Segarnick D, Tallarida R. Oxycodone combinations for pain relief. Drugs Today. 2010;46:379-398.
65. Edwards J, Moore R, McQuay H. Single dose oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database Syst Rev. 2000;4:CD002763.
66. Dhillon S. Tramadol/paracetamol fixed-dose combination: a review of its use in the management of moderate to severe pain. Clin Drug Investig. 2010;30:711-738.
67. Toms L, Derry S, Moore R, McQuay H. Single dose oral paracetamol (acetaminophen) with codeine for postoperative pain in adults. Cochrane Database Syst Rev. 2009;1:CD001547.
68. Tallarida R. Drug synergism: its detection and applications. J Pharmacol Exp Ther. 2001;298:865-872.
69. Tallarida R. An overview of drug combination analysis with isobolograms. J Pharm Exp Ther. 2006;319:1-7.
70. Tallarida R. Interactions between drugs and occupied receptors. Pharmacol Ther. 2007;113:197-209.
71. Tallarida R, Raffa R. The application of drug dose equivalence in the quantitative analysis of receptor occupation and drug combinations. Pharmacol Ther. 2010;127:165-174.
72. Legeby M, Sandelin K, Wickman M, Olofsson C. Analgesic efficacy of diclofenac in combination with morphine and paracetamol after mastectomy and immediate breast reconstruction. Acta Anaesthesiol Scand. 2005;49:1360-1366.
73. Miranda H, Puig M, Prieto J, Pinardi G. Synergism between paracetamol and nonsteroidal anti-inflammatory drugs in experimental acute pain. Pain. 2006;121:22-28.
74. Hyllested M, Jones S, Pedersen J, Kehlet H. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth. 2002;88:199-214.
75. Gatti A, Sabato E, DiPaolo A, Mammucari M, Sabato A. Oxycodone/paracetamol: a low-dose synergic combination useful in different types of pain. Clin Drug Investig. 2010;30:3-14.
76. Hama A, Sagen J. Cannabinoid receptor-mediated antinociception with acetaminophen drug combinations in rats with neuropathic spinal cord injury pain. Neuropharmacology. 2010;58:758-766.
77. Salihoglu Z, Yildirim M, Demiroluk S, et al. Evaluation of intravenous paracetamol administration on postoperative pain and recovery characteristics in patients undergoing laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2009;19:321-323.
78. Memis D, Inal M, Kavalci G, Sezer A, Sut N. Intravenous paracetamol reduced the use of opioids, extubation time, and opioid-related adverse effects after major surgery in intensive care unit. J Crit Care. 2010;25:458-462.
79. Jokela R, Ahonen J, Seitsonen E, Marjakangas P, Korttila K. The influence of ondansetron on the analgesic effect of acetaminophen after laparoscopic hysterectomy. Clin Pharmacol Ther. 2010;87:672-678.
80. Hahn T, Mogensen T, Lund C, et al. Analgesic effect of i.v. paracetamol: possible ceiling effect of paracetamol in postoperative pain. Acta Anaesthesiol Scand. 2003;47:138-145.
81. Peduto V, Ballabio M, Stefanini S. Efficacy of propacetamol in the treatment of postoperative pain: morphine-sparing effect in orthopedic surgery. Acta Anaesthesiol Scand. 1998;42:293-298.
82. Silvanto M, Munsterhjelm E, Savolainen S, et al. Effect of 3g of intravenous paracetamol on post-operative analgesia, platelet function and liver enzymes in patients undergoing tonsillectomy under local anaesthesia. Acta Anaesthesiol Scand. 2007;51:1147-1154.
83. Remy C, Marret E, Bonnet F. Effects of acetaminophen on morphine side-effects and consumption after major surgery: meta-analysis of randomized controlled trials. Br J Anaesth. 2005;94:505-513.
84. Schug S, Sidebotham D, McGuinnety M, Thomas J, Fox L. Acetaminophen as an adjunct to morphine by patient-controlled analgesia in the management of acute postoperative pain. Anesth Analg. 1998;87:368-372.
85. Elia N, Lysakowski C, Tramer M. Does multimodal analgesia with acetaminophen, nonsteroidal antiinflammatory drugs or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone? Meta-analyses of randomized trials. Anesthesiology. 2005;103:1296-1304.
86. Maund E, McDaid C, Rice S, Wright K, Jenkins B, Woolacott N. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine-related side-effects after major surgery: a systematic review. Br J Anaesth. 2011;106:292-297.
87. Macario A, Royal M. A literature review of randomized clincal trials of intravenous acetaminophen (paracetamol) for acute postoperative pain. Pain Pract. 2011;11:290-296.
88. Aubrun F, Kalfon F, Mottet P, et al. Adjunctive analgesia with intravenous propacetamol does not reduce morphine-related adverse effects. Br J Anaesth. 2003;90:314-319.
89. Hong J-Y, Kim W, Chung W, Yun J, Kil H. Paracetamol reduces postoperative pain and rescue analgesic demand after robot-assisted endoscopic thyroidectomy by the transaxillary approach. World J Surg. 2010;34:521-526.
90. Cakan T, Inan N, Culhaoglu S, Bakkal K, Basar H. Intravenous paracetamol improves the quality of postoperative analgesia but does not decrease narcotic requirements. J Neurosurg Anesthesiol. 2008;20:169-173.
91. Tiippana I, Bachmann M, Kalso E, Pere P. Effect of paracetamol and coxib with or without dexamethasone after laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2008;52:673-680.
92. Salonen A, Silvola J, Kokki H. Does 1 or 2g paracetamol added to ketoprofen enhance analgesia in adult tonsillectomy patients? Acta Anaesthesiol Scand. 2009;53:1200-1206.
93. Ohnesorge H, Bein B, Hanss R, et al. Paracetamol versus metamizol in the treatment of postoperative pain after breast surgery: a randomized, controlled trial. Eur J Anaesthesiol. 2009;26:648-653.
94. Kampe S, Warm M, Landwehr S, et al. Clinical equivalence of IV paracetamol compared to IV dipyrone for postoperative analgesia after surgery for breast cancer. Curr Med Res Opin. 2006;22:1949-1954.
95. Moon Y-E, Lee Y-K, Lee J, Moon D-E. The effects of preoperative intravenous acetaminophen in patients undergoing abdominal hysterectomy. Arch Gynecol Obstet. 2011;[Epub ahead of print].
96. Wininger S, Miller H, Minkowitz H, et al. A randomized, double-blind, placebo-controlled, multicenter, repeat-dose study of two intravenous acetaminophen dosing regiments for the treatment of pain after abdominal laparoscopic surgery. Clin Ther. 2010;32:2348-2368.
97. Pettersson P, Jakobsson J, Owall A. Intravenous acetaminophen reduced the use of opioids compared with oral administration after coronary artery bypass grafting. J Cardiothoracic Vasc Anesth. 2005;19:306-309.
98. McClellan K, Scott L Tramadol/paracetamol. Drugs. 2003;63:1079-1086.
99. Sawaddiruk P, Paiboonworachat S, Janthawichai K. Comparison of efficacy and effectiveness between ULTRACET and tramadol/acetaminophen in acute postoperative pain after upper extremity surgery. J Med Assoc Thai. 2010;93:812-817.
100. Liu G, Wang J, Liu K, Snavely D. Confidence intervals for an exposure adjusted incidence rate difference with applications to clinical trials. Stat Med. 2006;25:1275-1286.
101. Hawton K, Ware C, Mistry H, et al. Paracetamol self-poisoning: charcteristics, preention and harm reduction. Br J Pscyhiatry. 1996;168:43-48.
102. Kuffner E, Dart R, Bogdan G, Hill R, Casper E, Darton L. Effect of maximal daily doses of acetaminophen on the liver of alcholic patients. Arch Intern Med. 2001;161:2247-2252.
103. Juhl G, Norholt S, Tonnesen E, Hiesse-Provost O, Jensen T. Analgesic efficacy and safety of intravenous paracetamol (acetaminophen) administered as a 2g starting dose following third molar surgery. Eur J Pain. 2006;10:371-377.
104. Raffa R, Clarc-Vetri R, Tallarida R, Wertheimer A. Combination strategies for pain management. Expert Opin Pharmacother. 2003;4:1697-1708.
105. McQuay H, Edwards J, Moore R. Evaluating analgesia: the challenges. Am J Ther. 2002;9:179-187.
106. Moore A, Collins S, Carroll D, McQuay H. Paracetamol with and without codeine in acute pain: a quantitative systematic review. Pain. 1997;70:193-201.
107. Gray A, Kehlet H, Bonnet F, Rawal N. Predicting postoperative analgesia outcomes: NNT league tables or procedure-specific evidence? Br J Anaesth. 2005;94:710-714.
108. Kehlet H. Acute pain control and accelerated postoperative surgical recovery. Surg Clin North Am. 1999;78:431-443.
109. Raffa R. Pharmacology of oral combination analgesics: rational therapy for pain. J Clin Pharmacol Ther. 2001;26:257-264.
110. Pherro J. Contemporary trends in acute pain management. Curr Opin Otolaryngol Head Neck Surg. 2004;12:209-216.
111. Krenzelok E. The FDA Acetaminophen Advisory Committee Meeting - what is the future of acetaminophen in the United States? The perspective of a committee member. Clin Toxicol. 2009;47:784-789.
112. Barkin R. Acetaminophen, aspirin, or ibuprofen in combination analgesic products. Am J Ther. 2001;8:433-442.
113. Candiotti K, Bergese S, Viscusi E, Singla S, Royal M, Singla N. Safety of multiple-dose intravenous acetaminophen in adult inpatients. Pain Med. 2010;11:1841-1848.
114. Gregoire N, Hovsepian L, Gualano V, Evene E, Dufour G, Gendron A. Safety and pharmacokinetics of paracetamol following intravenous administration of 5g during the first 24h with a 2-g starting dose. Clin Pharmacol Ther. 2007;81:401-405.
115. Moller P, Juhl G, Payne-Champenois C, Skoglund L. Intravenous acetaminophen (paracetamol): comparable analgesic efficacy, but better local safety than its prodrug, propacetamol, for postoperative pain after third molar surgery. Anesth Analg. 2005;101:90-96.
116. Bektas F, Eken C, Karadeniz O, Goksu E, Cubuk M, Cete Y. Intravenous paracetamol or morphine for the treatment of renal colic: a randomized, placebo-controlled trial. Ann Emerg Med. 2009;54:568-574.
117. Cattabriga I, Pacini D, Lamazza G, et al. Intravenous paracetamol as adjunctive treatment of postoperative pain after cardiac surgery: a double blind randomized controlled trial. Eur J Cardio-Thorac Surg. 2007;32:527-531.
118. Kemppainen T, Kokki H, Tuomilehto H, Seppa J, Nuutinen J. Acetaminophen is highly effective in pain treatment after endoscopic sinus surgery. Laryngoscope. 2006;116:2125-2128.
119. Korkmaz-Dilmen O, Tunali Y, Cakmakkaya O, et al. Efficacy of intravenous paracetamol, metamizol and lornoxicam on postoperative pain and morphine consumption after lumbar disc surgery. Eur J Anaesthesiol. 2010;27:428-432.
120. Lahtinen P, Kokki H, Hendolin H, Hakala T, Hynynen M. Propacetamol as adjunctive treatment for postoperative pain after cardiac surgery. Anesth Analg. 2002;95:813-819.
121. Sinatra R, Jahr J, Reynolds L, Viscusi E, Groudine S, Payen-Champenois C. Efficacy and safety of single and repeated administration of 1 gram intravenous acetaminophen injection (paracetamol) for pain management after major orthopedic surgery. Anesthesiology. 2005;102:822-831.
122. Desjardins P, Black P, Daniels S, et al. A double-blind randomized controlled trial of rofecoxib and multidose oxycodone/acetaminophen in dental impaction pain. Oral Maxillofac Surg. 2007;65:1624-1632.
123. Franceschi F, Buccelletti F, Marsillani D, et al. Acetaminophen plus codeine compared to ketorolac in polytrauma patients. Eur Rev Med Pharmacol Sci. 2010;14:629-634.
124. Gammaitoni A, Daler B, Bulloch S, et al. Randomized, double-blind, placebo-controlled comparison of analgesic efficacy of oxycodone 10mg/acetaminophen 325mg versus controlled-release oxycodone 20mg in postsurgical pain. J Clin Pharmacol. 2003;43:296-304.
125. Rajpal S, Gordon D, Pellino T, et al. Comparion of oral multimodal analgesia versus IV PCA for spine surgery. J Spinal Disord Tech. 2010;23:139-145.
126. Trabulsi E, Patel J, Viscusi E, Gomella L, Lallas C. Preemptive multimodal pain regimen reduces opioid analgesia for patients undergoing robotic-assisted laparoscopic radical prostatectomy. Laparoscopy Robotics. 2010;76:1122-1124.
127. Derry S, Barden J, McQuay H, Moore R. Single dose oral celecoxib for postoperative pain. Cochrane Database Syst Rev. 2008;4:CD004233.
128. Collins S, Moore R, McQuay H, Wiffen P, Edwards J. Single dose oral ibuprofen and diclofenac for postoperative pain. Cochrane Database Syst Rev. 2000;2:CD001548.
129. Smith L, Moore R, McQuay H, Gavaghan D. Using evidence from different sources: an example using paracetamol 1000mg plus codeine 60mg. BMC Med Res Methodol. 2001;1:1.
130. Toms L, McQuay H, Derry S, Moore R. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults. Cochrane Database Syst Rev. 2008;4:CD004602.
131. Oldman A, Smith L, Collins S, et al. Single dose oral aspirin for acute pain. Cochrane Database Syst Rev. 2000;2:CD002067.
132. Moore R, McQuay H. Single-patient data meta-analysis of 3453 postoperative patients: oral tramadol versus placebo, codeine, and combination analgesics. Pain. 1997;69:287-294.
133. Gaskell H, Derry S, Moore R, McQuay H. Single dose oral oxycodone and oxycodone plus paracetamol (acetaminophen) for acute postoperatiove pain in adults. Cochrane Database Syst Rev. 2009;3:CD002763.
134. Pergolizzi J, ed. Multimodal Analgestic Therapy. Philadelphia: Saunders Elsevier; 2006. Shorten G, Carr D, Harmon D, Puig M, Browne J, eds. Postoperative Pain Management: An Evidence-Based Guide to Practice; No. Chapter 19.