Anesthesiology 2013: IV Acetaminophen for Pediatric Tonsillectomies

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The Particulars: Data indicate that more than 80% of tonsillectomies are performed to correct breathing disorders that affect sleep, mostly sleep apnea. A previous study found that children with sleep apnea were highly sensitive to opioids. Use of intravenous (IV) acetaminophen in children undergoing tonsillectomy may limit the need for opioids in this patient population.

Data Breakdown: For a study, investigators compared pain levels and costs among children undergoing tonsillectomy who received IV acetaminophen plus opioids to those who received opioids alone during post-anesthesia care. The combination therapy was less expensive and more effective in reducing the need for rescue analgesics than opioids alone. Cost savings were realized due to fewer side effects and shorter times spent in the post-anesthesia care unit.

Take Home Pearls: Among children undergoing tonsillectomy, the combination of IV acetaminophen and opioids appears to be more effective in providing pain relief than opioids alone. The combination approach also appeared to be less expensive than using only opioids.


  1. What about oral Preop acetaminophen instead of IV acetaminophen to reduce opioid use?

    • Randall, that’s exactly what I do in my practice and I have had great success with it. IV vs oral acetaminophen regimens need to be more carefully studied.


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