A common concern among patients considering joint replacement is how much pain they’ll experience after surgery. Pain control is a top priority at HSS. In addition to avoiding discomfort, it’s essential to get a handle on pain early on so patients can move around and engage in a physical therapy program.
At HSS, we’ve studied pain control at length and have excellent pain management protocols for patients who have joint replacement. We generally strive to decrease the use of narcotic medications known as opioids. Although these medications do a good job at controlling pain, they can have side effects such as nausea, vomiting, dizziness, drowsiness and constipation, which are not only unpleasant, but can make physical therapy more difficult.
Our latest pain control study seeks to determine if intravenous (IV) acetaminophen can reduce the amount of opioid pain medicine needed after hip replacement surgery. Currently, joint replacement patients generally receive opioid medication along with the pill form of acetaminophen, commonly known as Tylenol.
We decided to undertake this study because research shows that acetaminophen in IV form reaches a peak concentration in the blood much faster than oral acetaminophen. Therefore, it may be better at reducing pain than the pill form.
All of the patients in the study will receive the standard pain control protocol, with one group getting IV acetaminophen, while the other group receives the oral pill form. Our goal is to see if intravenous acetaminophen works better than the pill form and can lead to lower doses of opioid medication and more rapid attainment of physical therapy goals.
In addition to seeing if IV acetaminophen can reduce the need for opioid medication, we will be measuring sedation effects and length of hospital stay in patients given intravenous versus oral acetaminophen.
Because of its efficacy, general safety and lower risk of adverse effects compared to other pain medications, IV acetaminophen could be a beneficial component of the overall pain management plan. If we find that the IV form safely reduces the need for opioid medication, it could be advantageous for hip replacement patients.
Dr. Geoffrey Westrich, Orthopedic Surgeon, specializes in hip and knee replacement, including revision surgery and complex cases at Hospital for Special Surgery. He is director of research of the Adult Reconstruction and Joint Replacement Service at HSS.