IV Acetaminophen as an Analgesic Adjunct

Exclusion Criteria

• •Use of other opioids or tramadol within past 24 hours: to avoid introducing assembly bias related to recent opioid use, since this may affect baseline levels of pain and need for analgesics.
• •Prior adverse reaction to hydromorphone, morphine, or acetaminophen.
• •Chronic pain syndrome: frequently recurrent or daily pain for at least 3 months results in modulation of pain perception which is thought to be due to down-regulation of pain receptors. Examples of chronic pain syndromes include sickle cell anemia, osteoarthritis, fibromyalgia, and peripheral neuropathies.
• •Alcohol intoxication: the presence of alcohol intoxication as judged by the treating physician may alter pain perception.
• •Systolic Blood Pressure (SBP) \<100 mm Hg: Opioids can produce peripheral vasodilation that may result in orthostatic hypotension.
• •Heart Rate (HR) \< 60/min: Opioids can cause bradycardia.
• •Oxygen saturation \< 95% on room air: For this study, oxygen saturation must be 95% or above on room air in order to be enrolled.
• •Use of monoamine oxidase (MAO) inhibitors in past 30 days: MAO inhibitors have been reported to intensify the effects of at least one opioid drug causing anxiety, confusion and significant respiratory depression or coma.
• •Patients using transdermal pain patches