A Trial of the Cost Effectiveness of IV Acetaminophen in Bariatric Surgery
Hospital Costs, Length of Stay, Postoperative Pain Score
About this trial
This is an interventional treatment trial for Hospital Costs focused on measuring Acetaminophen, Gastric Bypass, Sleeve Gastrectomy, Pain, Cost
Eligibility Criteria
Inclusion Criteria:
- age > 18
- attendance at an informational seminar and support group
- clearance for surgery by a registered dietician and certified social worker
- BMI > 35 with at least one co-morbid condition (e.g., hypertension, diabetes mellitus, sleep apnea, hypercholesterolemia) or BMI > 40 without any co-morbid conditions
- negative pregnancy test
- American Society of Anesthesiology score 1-3
- ability to understand instructions and comply with all study requirements
- preoperative %excess weight loss (%EWL) of 3-10%
- no contraindication for a LRYGB or LSG based on upper endoscopy findings
- preoperative cardiac consultation for risk stratification
- evaluation by a sleep medicine specialist to identify risk factors for sleep apnea, with treatment as deemed appropriate
Exclusion Criteria:
- revisional surgery
- conversion to open procedure
- chronic musculoskeletal pain
- narcotics or NSAIDs use in the 7 days prior to surgery
- history of fibromyalgia
- sensitivity to acetaminophen or liver disease (i.e., elevated LFT or history of hepatitis or liver failure)
- use of monoamine oxidase inhibitor in the 7 days prior to surgery
- use of any medication containing acetaminophen
- allergy to morphine or oxycodone
Sites / Locations
- St Luke's University Hospital
- St Luke's University Health Network
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Treatment
Control
Group 1 (treatment) will receive IV acetaminophen (1g in 100 ml of 0.9% normal saline IV Q 6hrs for 24 hours) plus IV narcotics (2-4 mg IV Q2hrs PRN) for the first 6 hours post-surgery followed by IV narcotics (2-4 mg IV Q2hrs PRN)/ PO narcotics (Oxycodone 5-10 ml PO Q4 hrs PRN) for the remaining 18 hours.
Group 2 (control) will receive IV normal saline (100 ml of 0.9% normal saline IV Q 6hrs for 24 hours) plus IV narcotics (2-4 mg IV Q2hrs PRN) for the first 6 hours post-surgery followed by IV narcotics (2-4 mg IV Q2hrs PRN)/ PO narcotics (Oxycodone 5-10 ml PO Q4 hrs PRN) for the remaining 18 hours.