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ASA: Standing Oral Acetaminophen Before Tonsillectomy Cuts IV Usage

Additional benefits include reducing variability and significant cost savings

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TUESDAY, Oct. 12, 2021 (HealthDay News) -- Administering oral acetaminophen to all pediatric patients undergoing tonsillectomy during the preoperative admission process reduces intravenous acetaminophen use, according to a study presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 8 to 12 in San Diego.

Melissa Brooks Peterson, M.D., from the University of Colorado School of Medicine in Aurora, and colleagues assessed the impact of giving oral acetaminophen (12.5 mg/kg oral acetaminophen; maximum dose, 650 mg) to all pediatric otorhinolaryngologic patients undergoing tonsillectomy with or without adenoidectomy during the preoperative admission process as part of the standing anesthesia preoperative order set.

The researchers found that changing from an "opt-in" model to an "opt-out" model dramatically reduced the amount of intravenous acetaminophen dispensed (−23.8 doses per month). The resultant cost savings was more than $27.00 per patient, yielding an annual savings of more than $50,000.

"Nurses find managing kids in the recovery room after tonsillectomies can be challenging because the children go into the procedure fine and can come out of surgery in extreme pain," Brooks Peterson said in a statement. "Under the new protocol, perioperative nurses control the acetaminophen dosing. Getting medication into the patient in a more reliable way reduces variability, improves care for our patients, and helps the nurses serve an important role in pain control."

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