Presentation Outline ICHP Annual Meeting September 13-15
Presentation Outline ICHP Annual Meeting September 13-15
Presentation Outline ICHP Annual Meeting September 13-15
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Decisions, Decisions…Debates in Therapeutics<br />
Injectable Acetaminophen:<br />
What is its role in postoperative<br />
pain p management? g<br />
Daniel T. Abazia, Pharm.D., BCPS<br />
Pharmacy Clinical Coordinator<br />
Palos Community Hospital<br />
Additional Goals<br />
By the end of this knowledge‐based educational activity,<br />
participants should be able to:<br />
1. Explain the clinical and economic consequences of inadequate<br />
control of postoperative p p pain. p<br />
2. Identify elements of multimodal postoperative analgesia.<br />
3. Discuss clinical data for using injectable acetaminophen for<br />
management of postoperative pain.<br />
4. Describe the practical aspects of utilizing injectable<br />
acetaminophen within the acute care setting.<br />
Impact of Postoperative Pain<br />
Negative CLINICAL Outcomes:<br />
• Cognitive dysfunction<br />
• Coronary ischemia / myocardial infarction<br />
• Deep vein thrombosis / pulmonary embolism<br />
• Insomnia<br />
• Pneumonia<br />
• Poor wound healing and recovery<br />
Apfelbaum JL, Chen C, Mehta SS, et al. Postoperative pain experience: results of from a national survey suggest<br />
postoperative pain continues to be undermanaged. Anesth Analg. 2003; 97:534‐40.<br />
Kehlet H, Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth. 2001;87:62‐72.<br />
Disclosures<br />
The speaker has no actual or potential conflict of<br />
in relation to this presentation.<br />
Palos Community Hospital<br />
• Located in southwest<br />
suburbs of Chicago, IL<br />
• Community, non‐teaching<br />
• 436 licensed beds<br />
• Pharmacy satellite in OR<br />
2011 surgical statistics<br />
‐ Inpatient procedures: 3,993<br />
‐ Outpatient procedures: 4,575<br />
Postop Pain: Link to Chronic Pain<br />
• Retrospective analysis<br />
• Evaluated patients undergoing thoracotomy who developed<br />
chronic pain (n = 78) vs. those who did not (n = 71) one week<br />
postop<br />
• Pti Patients t who h ddeveloped l dchronic h i pain i hdi had increased... d<br />
� ↑ incidence of acute pain (p = 0.002)<br />
� ↑ severity of acute pain (p = 0.0001)<br />
� ↑ total �me having pain (p = 0.02)<br />
• Progression to chronic pain increased with intensity of acute<br />
postoperative pain<br />
Pluijms WA, Steegers MA, Verhagen AF, et al. Chronic post-thoracotomy pain: a retrospective<br />
study. Acta Anaesthesiol Scand. 2006; 50:804-8.<br />
8/29/2012<br />
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