Effectiveness of acetaminophen in control of breakthrough pain: Randomized controlled trial

J Pak Med Assoc. 2018 Jul;68(7):994-1001.


Objective: To reduce postoperative pain by using additional analgesic agent in between the usual parenteral analgesia that is used in the postoperative period in surgical patients.

Methods: The double-blind, randomised control intervention was conducted from June to November 2015 at Rehman Medical Institute, Peshawar, Pakistan, and comprised postoperative surgical patients of either gender aged 18 or more who had undergone uneventful elective surgery The subjects were divided into test and placebo groups. In the test group, 1gm acetaminophen was additionally prescribed, while in the control group placebo (starch) was administered. Demographics were noted and pain score was recorded using three internationally validated pain scales; Verbal pain intensity scale, Visual analogue scale, and Numeric pain scale. SPSS version 15.0 is used for calculation. Data was collected twice over 48 hours.

Results: Out of 220 patients, 165(75 %) were male with mean age 31.5±1.93 years and 55(25%) were female with mean age 31.5±1.48 years. There were 118(53.6%) patients in the test group and 102(43.4%) in the control group. In the first 24 hours the cumulative pain score, from numeric pain scale and visual analogue scale, for the control group showed 5(4.90%) patients had no pain, 39(38.24%) had mild pain, 52(50.98%) moderate pain and 6(5.80%) had severe pain. In the test group, 13(11.02%) reported no pain, 83(70.34%) had mild pain, 19(16%) had moderate pain while 3(2.54%) complained of severe pain. In the next 48 hours cumulative pain score in the test group showed 44(37.29%)subjects had no pain, 67(56.78%) had mild pain, 6(5.08%) had moderate pain, 1(0.85%) had severe pain, while in the control group 10(10%) had no pain, 56(55%) had mild pain, 33(32%) had moderate pain and 3(3%) had severe pain. .

Conclusions: Additional acetaminophen reduced mild to moderate pain between two doses of parenteral analgesia.

Keywords: Effectiveness of acetaminophen, Breakthrough pain, Parental analgesics ketorolac trometamine, Post surgical patients..

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / administration & dosage*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Non-Narcotic / administration & dosage
  • Breakthrough Pain / diagnosis
  • Breakthrough Pain / drug therapy*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult


  • Analgesics, Non-Narcotic
  • Acetaminophen