Course Videos
What is the clinical importance of avoiding the hepatic first-pass effect when using the IV versus oral formulation of acetaminophen, and what PK advantages and tissue penetration/compartment effects are observed that are responsible for improved efficacy?
Can you walk us through the practical and “best practice” aspects and roadmap for how to dose and infuse IV acetaminophen, including timing and duration of administration as part of an ERAS protocol?
From a safety and efficacy standpoint, what is the rationale for using such agents as IV acetaminophen as part of multimodal analgesia to reduce overall opioid consumption?
Do we have studies that provide information about the comparative efficacy of non-opioid agents used as part of multimodal perioperative pain management? And what about comparative safety?
Is there a patient preference component that is a significant driver to helping select agents for multimodal therapy? And what about expectations as part of the ERAS pathway?
How does the MOA of IV acetaminophen suggest how to combine it with other agents as part of multimodal management for ERAS?
What are the mechanism(s) of action by which IV acetaminophen exerts its pain-relieving properties and how is this differentiated from other agents?
Are there any situations where you might consider the use of IV acetaminophen as part of monotherapy for certain surgical procedures, as opposed to its use as a non-opioid foundational agent that is part of a multimodal approach requiring rescue with opioids?
What is the optimal dosing schedule for IV acetaminophen and how should it be combined with opioid therapy?
What is the evidence that opioid-related side effects compromise patient-related outcomes and satisfaction? And prolong LOS?
What are the ASA/APS guideline recommendations for multimodal perioperative pain management and how important are opioids as drivers to prolongation of LOS associated with surgical procedures?
In your discussions with many other cardiac surgery centers focused on reducing opioid use and pushing forward ERAS-based protocols, what consensus, if any, have you seen regarding IV acetaminophen use?