Maher El Chaar, MD

Maher El Chaar, MD
 

Co-Medical Director of Bariatric Surgery
St Luke’s University Hospital
Allentown, Pennsylvania


What do studies show about the use of IV acetaminophen as part of multimodal perioperative pain management and hospital length of stay for various surgical procedures?

What do studies show about the relationship between the use of IV acetaminophen as part of multimodal perioperative pain management and hospital length of stay for various surgical procedures?

What is the optimal dosing for deploying IV acetaminophen and how should it be combined with opioid therapy?

What is the optimal dosing for deploying IV acetaminophen and how should it be combined with opioid therapy?

In addition to IV acetaminophen pre-op and post-op, how do you combine it with opioids? Do you use the IV narcotic as a primary pain reliever in bariatric surgery or as a rescue medication?

In addition to administering IV acetaminophen pre-op and post-op, how do you combine it with opioid therapy? Do you use the IV narcotic as a primary pain reliever in bariatric surgery or as a rescue medication?

Based on the evidence for efficacy of IV versus PO acetaminophen, which route do you prefer in bariatric surgery and why? How long do you give IV acetaminophen prior to switching to PO?

Based on the evidence for efficacy of IV versus PO acetaminophen, which route do you prefer in the setting of bariatric surgery and why? How long do you give IV acetaminophen, typically, in the case of bariatric surgery, prior to switching to PO?

What is the safety profile of IV acetaminophen? And what makes this safety and side effect profile uniquely suited to multimodal pain relief in bariatric patients undergoing bariatric surgery?

What is the safety profile of IV acetaminophen? And what makes this safety and side effect profile uniquely suited to multimodal pain relief in bariatric patients undergoing bariatric surgery? How do you counsel the patient pre-operatively ...

Are there any contraindications to the use of IV acetaminophen in the setting of bariatric or other surgical procedures? What are the implications for dosing and/or dose reduction?

Are there any contraindications to the use of IV acetaminophen in the setting of bariatric or other surgical procedures? What are the implications for dosing and/or dose reduction?

How does the use of IV acetaminophen differ from the use of oral acetaminophen? Do GI symptoms -- nausea, vomiting and intolerance to PO intake --affect your decision?

How does the use of IV acetaminophen differ from the use of oral acetaminophen, especially when used in conjunction with IV opioid therapy? Do GI symptoms — nausea, vomiting and intolerance to PO intake — or concerns about malabsorption ...

How did you address the issue of (a) poor pain control and/or (b) recurrent emergency department visits and/or hospital readmissions in your patients who underwent bariatric surgery?

How did you address the issue of (a) poor pain control and/or (b) recurrent emergency department visits and/or hospital readmissions in your patients who underwent bariatric surgery? And how did your study help identify solutions and/or ...

Can you summarize your study results evaluating cost-savings and clinical metric improvements using IV acetaminophen within multimodal pain management for bariatric surgery?

Can you summarize and discuss the trial design and results of your study published in JGS (J Gastrointest Surg. 2016 Apr;20(4):715-24) evaluating cost-savings and clinical metric improvements using IV acetaminophen as a core agent within ...

What time parameters did you use for tracking reduction in ED visits and hospital readmissions associated with IV acetaminophen use? And what about the need to use rescue narcotics?

What time parameters did you use for tracking reduction in emergency department visits and hospital readmissions associated with IV acetaminophen use? And what about the need to use rescue narcotics?

With respect to reduction in overall costs associated with deployment of pre- and post-operative IV acetaminophen in bariatric surgery, where did you observe the greatest cost savings?

With respect to reduction in overall costs — including direct and indirect costs — associated with deployment of pre- and post-operative IV acetaminophen in bariatric surgery patients, where did you observe the greatest cost savings in ...

What differences in quality-of-life and/or patient-reported pain measures or scores did you observe in the group treated with IV acetaminophen?

What differences in quality-of-life and/or patient-reported pain measures or scores did you observe in the group treated with IV acetaminophen?

Did your study show that the group that received IV acetaminophen incurred fewer emergency department visits, hospital readmissions, pain-related complaints, and lower indirect costs?

Did your study essentially show that even though pain scores did not differ significantly during the post-op 24 hour period between the groups that did and did not receive IV acetaminophen, during the 30-day post-op observation period, ...

What are the pharmacoeconomic and "pain management policy" implications of your study evaluating costs and clinical metrics in bariatric surgery patients managed with IV acetaminophen?

What are the pharmacoeconomic and “pain management policy” implications of your study evaluating differential costs and clinical metrics in bariatric surgery patients managed with IV acetaminophen? What are the institutional and patient ...

Why do bariatric surgery patients represent an ideal patient population for use of IV acetaminophen as a part of multimodal post-operative pain management?

Why do bariatric surgery patients represent an ideal patient population for use of IV acetaminophen as a part of multimodal post-operative pain management?

Why is the exclusive use of IV opioids in bariatric surgery patients problematic and why is IV acetaminophen uniquely qualified to be part of multimodal post-operative pain management?

Why is the exclusive use of IV opioids in bariatric surgery patients problematic and why is IV acetaminophen uniquely qualified to be part of multimodal post-operative pain management?

Do you use IV acetaminophen as part of a standardized protocol or do you select patients you think are appropriate for this approach based on specific criteria?

Do you use IV acetaminophen as part of a standardized protocol or do you select patients you think are appropriate for this approach based on specific criteria?

Are there situations where you might consider IV acetaminophen as monotherapy, as opposed to its use as a non-opioid agent that is part of a multimodal approach requiring rescue with opioids?

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?

How does the side effect profile of acetaminophen compare with placebo or other non-opioid agents?

How does the side effect profile of acetaminophen compare with placebo or other non-opioid agents?

Are there are surgical procedures outside the context of bariatric surgery where you think this approach to pain control may provide similar advantages?

Clearly, your clinical experience has established the efficacy, safety and cost-effectiveness associated with IV acetaminophen in the setting of bariatric surgery, but are there are surgical procedures outside this context where you think ...

What unique aspects of your trial design do you think are worth emphasizing? What are the take-home messages about the mechanism(s) by which IV acetaminophen reduces indirect costs?

In summary, what unique aspects of your trial design (J Gastrointest Surg. 2016 Apr;20(4):715-24) do you think are worth emphasizing? And what are the take-home messages about the mechanism(s) by which IV acetaminophen reduces indirect costs?