Assessing efficacy of intravenous acetaminophen for perioperative pain control for oocyte retrieval: a randomized, double-blind, placebo-controlled trial

The routine use of preoperative intravenous acetaminophen before oocyte retrieval does not reduce postoperative pain scores or shorten the time to discharge when compared with oral acetaminophen or placebo.

Like Comment
Related Content

VOLUME 117, ISSUE 1, P133-141

Authors:

Caitlin R. Sacha, M.D., Roisin Mortimer, M.B.B.C.H.B.A.O., Eduardo Hariton, M.D., Kaitlyn James, Ph.D., Afrooz Hosseini, M.D., Morgan Gray, M.S., Chengluan Xuan, M.D., Ph.D., Karissa Hammer, M.D., Allison Lange, M.D., Shruthi Mahalingaiah, M.D., Jingping Wang, M.D., John C. Petrozza, M.D.

Abstract:

Objective

To compare the effect of preoperative intravenous (IV) acetaminophen versus oral (PO) acetaminophen or placebo on postoperative pain scores and the time to discharge in women undergoing oocyte retrieval.


Design

Randomized, double-blind, placebo-controlled trial.


Setting

Single academic fertility center.


Patient(s)

Women aged 18–43 years undergoing oocyte retrieval.


Intervention(s)

Randomization to preoperative 1,000 mg IV acetaminophen and PO placebo (group A), IV placebo and 1,000 mg PO acetaminophen (group B), or IV and PO placebo (group C)


Main Outcome Measure(s)

Difference in patient-reported postoperative visual analog scale pain scores from baseline and the time to discharge.


Result(s)

Of the 159 women who completed the study, there were no differences in the mean postoperative pain score differences or the time to discharge. Although not statistically significant, the mean postoperative opioid dose requirement in group A was lower than that in groups B and C (0.24 vs. 0.59 vs. 0.58 mg IV morphine equivalents, respectively) due to fewer women in group A requiring rescue pain medication (8% vs. 19% vs. 15%, respectively). Group A also reported less constipation when compared with groups B and C (19% vs. 33% vs. 40%, respectively). The rates of postoperative nausea were similar, and there were no differences in embryology or early pregnancy outcomes between the study groups.


Conclusion(s)

Preoperative IV acetaminophen for women undergoing oocyte retrieval did not reduce postoperative pain scores or shorten the time to discharge when compared with PO acetaminophen or placebo and, thus, cannot currently be recommended routinely in this patient population.


Clinical Trial Registration Number

NCT03073980.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.