T. Bernaiche1, G. Hafner1 1Inova Fairfax Hospital,Falls Church, VA, USA
Introduction:
Post-operative pain continues to be a significant problem, even after minimally invasive ambulatory procedures. Our study assesses if administering Neurontin and Tylenol prior to incision can decrease pain scores, PACU length of stay, and post-operative narcotic requirements after laparoscopic cholecystectomies and laparoscopic inguinal hernia repairs.
Methods:
Records of a single surgeon’s laparoscopic hernias and laparoscopic cholecystectomies from 2013-2014 were reviewed. Differences between patients who received pre-operative Tylenol and Neurontin (PTN group) and those who did not (non-PTN group) were assessed using Student’s t test or Wilcoxon-Mann Whitney test and χ2 test or Fisher exact test.
Results:
173 patients were included in the study (76 laparoscopic cholecystectomy and 97 laparoscopic inguinal hernia repair). There were 74 patients in the PTN group and 99 patients in the non-PTN group. Patients in the PTN group were less likely to receive post-operative narcotics (85.9% vs 97.3% [p=0.01]). There was also a decrease in the median number of doses of post-operative narcotics received in the PTN group (2 (IQR 1-2) vs 2 (IQR 1-3) [p=0.029]). There were no differences in pain scores between the two groups. The PTN group had an increased PACU length of stay (179 min vs 142 min [p=0.005]). The results remained unchanged after stratifying by surgery.
Conclusions:
Our study suggests that pre-operative Tylenol and Neurontin may play a role in decreasing post-operative narcotics use for laparoscopic hernia or laparoscopic cholecystectomy patients. Further investigation with prospective, randomized studies would clarify the utility of standardizing pre-operative Tylenol and Neurontin.