Outcome of IV Acetaminophen Use in Laparoscopic Cholecystectomies in Patients at Risk of OSA
Outcome of IV Acetaminophen Use in Laparoscopic Cholecystectomies in Patients at Risk of OSA
The objective of this study is to determine if IV acetaminophen administered intraoperatively
 can decrease the dose of narcotics required for adequate pain control and shorten recovery
 time in the PACU specifically in obese patients at risk for obstructive sleep apnea.
Obese adult patients at risk for having OSA will be randomized into two groups: those
 receiving intraoperative IV acetaminophen and those not receiving the drug. The patients will
 be blinded to the administration of acetaminophen. For the group randomized to receive the
 study drug, anesthesia providers will be instructed to administer 1000mg of IV acetaminophen
 intraoperatively immediately after induction. They may utilize narcotics and other pain
 medication perioperatively at their discretion according to their perceived patients' needs.
 Post-operatively in the recovery unit, all patients will be monitored according to current
 standards with appropriate oxygen supplementation as needed, and they may receive narcotics
 or other adjuncts as ordered by the anesthesia provider. Recovery nurses will record vital
 signs, Aldrete score, pain score, and drugs administered per standard protocol. The recovery
 nurses will be blinded to the study group, and no patients regardless of control vs. study
 group will be allowed to receive acetaminophen in the PACU or for six hours from surgery end
 time due to FDA approved dosing of IV acetaminophen no more frequently than every six hours.
 The patients' recovery data will then be de-identified and reviewed, and each of the groups'
 recovery time, narcotic use, pain score, and any complications will be examined and compared.
Inclusion Criteria:

 -  Obesity (BMI greater than or equal to 30)

 -  Symptoms of obstructive sleep apnea as determined by an OSA questionnaire patients
 will complete preoperatively

 -  Prior diagnosis of obstructive sleep apnea

 -  Undergoing laparoscopic cholecystectomy

 -  18 years old or greater

 Exclusion Criteria:

 -  Negative OSA questionnaire or recent negative workup

 -  Open cholecystectomy or conversion to open procedure intraoperatively

 -  Allergy to acetaminophen

 -  Severe hepatic dysfunction

 -  Pediatric patients

 -  Patients unable to consent for themselves