Pre-Emptive vs. Postincision Acetaminophen for Postoperative Pain .
Pre-Emptive Acetaminophen for Postoperative Pain (PAPP): An Updated Meta-Analysis.
J Perianesth Nurs . 2025 Apr;40(2):415-421.e4.Twelve studies including 845 adult surgical patients were included in this systematic review and meta-analysis comparing pre-emptive intravenous acetaminophen with postincision acetaminophen. Pooled outcomes of interest included 24-hour morphine consumption, postoperative vomiting, time to analgesic request, pain scores at 6 and 24 hours, and pruritus. Pre-emptive acetaminophen significantly reduced 24-hour morphine consumption and postoperative vomiting, with no significant differences in other outcomes. These findings suggest that timing acetaminophen before incision may reduce postoperative opioid use and nausea, although evidence certainty remains very low.
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