Postoperative pain management using high-dose oral acetaminophen for enhanced recovery after colorectal cancer surgery.

Autor: Urakawa S; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan. urashin.1130@gmail.com.; Department of Gastroenterological Surgery, Osaka Habikino Medical Center, Osaka, Japan. urashin.1130@gmail.com., Shingai T; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan.; Department of Gastroenterological Surgery, Kinki Central Hospital, Osaka, Japan., Kato J; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan., Kidogami S; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan., Fukata T; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan., Nishida H; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan., Takemoto H; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan., Ohigashi H; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan., Fukuzaki T; Department of Gastroenterological Surgery, Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka, 565-0862, Japan.
Jazyk: angličtina
Zdroj: Surgery today [Surg Today] 2024 Nov 13. Date of Electronic Publication: 2024 Nov 13.
DOI: 10.1007/s00595-024-02962-3
Abstrakt: Purpose: Postoperative pain management is important for enhanced recovery. High-dose oral acetaminophen is effective; however, the safety of its long-term use has not been established in gastrointestinal surgeries. This study aimed to investigate drug-induced liver injury (DILI) in patients with colorectal cancer using high-dose acetaminophen.
Methods: One hundred sixty-eight consecutive colorectal cancer using high-dose oral acetaminophen (3600 mg/day between postoperative day 1 and 7) were enrolled.
Results: One hundred forty-nine patients (88.7%) completed the administration of high-dose oral acetaminophen. DILI occurred in 58 patients (34.5%), and the cumulative incidence rates were 20.4% and 37.9% on postoperative 6 and 7, respectively. The severity of liver injury was grade 1 in all cases and returned to normal without treatment. Patients with DILI had a higher frequency of dyslipidemia (44.8% vs. 23.6%, P = 0.0047) and M1 staging (10.3% vs. 1.0%, P = 0.0036). A multivariate analysis showed that the presence of dyslipidemia (OR 2.61, P = 0.0067) and M1 stage (OR 12.4, P = 0.0053) were independent risk factors for DILI.
Conclusion: The long-term use of high-dose oral acetaminophen in colorectal cancer patients enrolled in enhanced recovery protocols is feasible. Moreover, the presence of dyslipidemia and M status are risk factors for DILI.
Competing Interests: Declarations Conflict of interest Dr. Shinya Urakawa, Tatsushi Shingai, Junichiro Kato, Shinya Kidogami, Tadafumi Fukata, Hisashi Nishida, Hiroyoshi Takemoto, Hiroaki Ohigashi, and Takayuki Fukuzaki have no conflicts of interest or financial ties associated with this study.
(© 2024. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.)
Databáze: MEDLINE
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