UC Irvine

Burn injury is the cause of one of the most severe types of pain. Many studies have shown that burn pain management is inadequate in most burn centers. Multiple studies have shown that intravenous acetaminophen decreases the overall amount of narcotics administered as well as longer time until drug rescue. Intravenous acetaminophen can be incorporated into the multi-modal approach in order to reduce the amount of narcotic pain medications administered so that pain can be controlled more safely and effectively.

This retrospective study analyzed demographic characteristics, amount of narcotics administered on days with and without administration of intravenous acetaminophen prior to burn wound care and effects of multiple doses of intravenous acetaminophen in hepatic function. Forty one patients admitted to the University of California, Irvine Burn Center between August 2011 and August 2013 were included in the sample.

Comparing the average amount of narcotics administered on days with administration of IV acetaminophen showed no statistically significant difference when compared with amount of narcotics on days with no administration of IV acetaminophen. After performing subgroup analyses, there were reductions found in amount of narcotics on days when IV acetaminophen was administered. However, these reductions were not statistically significant. There was no deterioration in hepatic function after one or more doses of 1,000mg of intravenous acetaminophen throughout all of the 41 patient's hospital stays.

The results demonstrated the effectiveness of intravenous acetaminophen in certain groups. On the other hand, there were also groups in which intravenous acetaminophen was clearly ineffective. Furthermore, it has been shown that IV acetaminophen does not cause any potential health risks to the liver. The results of this study, in particular the subgroup analyses, may warrant further evaluation in a prospective, controlled setting. A prospective study would be used to determine whether the use of IV acetaminophen as an adjunct to use of increased dosages of narcotics during burn wound care will provide more effective and consistent pain relief to a larger segment of patients in a burn unit.