The American Society of Anesthesiologists Task Force on Acute Pain Management recommended in 2004 that acute postoperative pain be managed by multimodal techniques.
The goal was to administer 2 agents with different mechanisms via the same route in efforts to improve analgesic efficacy and reduce potential adverse effects from any single agent.
Although oral and rectal forms of acetaminophen (also known as paracetamol) have been effectively and safely used for analgesia and pyrexia for decades, an IV formulation (Ofirmev) was recently approved by the Food and Drug Administration. Ofirmev has been available in Europe since 2002 and was approved in the United States in 2010 for the management of mild to moderate pain, moderate to severe pain with adjunctive opioids, and fever reduction. Certain characteristics of IV acetaminophen make it an improved option for postoperative pain management over the oral and rectal formulations. They include improved bioavailability and faster onset of action. Studies have shown that IV acetaminophen is an effective alternative drug to use with opioids in multimodal analgesia.
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