Acetaminophen administered intravenously after surgery can provide effective analgesia in many cases. It has been used primarily in orthopedic surgery but can be used for many kinds.
In Europe propacetamol has been given intravenously for several years. Each gram of propacetamol is hydrolyzed to 0.5 g acetaminophen. However, it is associated with infusion site reactions and local phlebitis.
Acetaminophen is poorly soluble in water and not stable in solution. Recently a formulation has been developed which can be given intravenously.
One regimen for adults is 0.25 g acetaminophen in 100 mL solution infused over 15 minutes, given every 6 hours for 24 hours (total IV dose 1 g). Most patients required a rescue dose of an opiate about 3 hours after the infusion.
Advantages:
(1) rapid and effective analgesia
(2) superior kinetics to oral acetaminophen and can be given when there is decreased GI motility
(3) reduced need for opiates and other analgesics
(4) reduction in side effects such as nausea and vomiting
Disadvantages:
(1) relatively expensive
(2) potentially toxic if an overdose is administered
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