Pain Control in Elderly Hip Fracture Patients: Is Intravenous Acetaminophen Superior to Oral Administration?



Status:Terminated
Conditions:Orthopedic, Orthopedic
Therapuetic Areas:Orthopedics / Podiatry
Healthy:No
Age Range:65 - Any
Updated:2/9/2018
Start Date:December 2016
End Date:December 2016

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The primary objective is to determine if intravenous acetaminophen decreases pain scores and
the amount of morphine equivalence received as compared to oral acetaminophen in patients
greater than 65 years old after sustaining a hip fracture.

Surgeons involved in this research agree to the randomization of patients into one of two
groups. After informed consent, patients will be randomly assigned in a 1:1 ratio to the
treatment group or the control group.

Group 1: This group will serve as the control group, and will be scheduled to receive one
gram (1g) acetaminophen PO every 8 hours.

Group 2: This group will serve as the treatment group, and will be scheduled to receive one
gram (1g) acetaminophen IV every 8 hours

The standardized pain control protocol for hip fracture patients will be initiated for all
patients. The pain protocol will be initiated at hospital admission, and after three
postoperative doses of the group assigned acetaminophen all patients will be switched to one
gram scheduled acetaminophen PO in preparation for hospital discharge.

Inclusion Criteria:

1. Acute, isolated, unilateral femoral neck, intertrochanteric, and per trochanteric hip
fractures confirmed by anteroposterior/lateral hip radiographs, computed tomography,
or magnetic resonance imaging (MRI).

2. Age ≥ 65 years.

3. Low energy mechanism.

4. Hip fracture fixation performed within 48 hours of injury.

5. English speaking.

6. Anticipated medical optimization for operative fixation.

7. No other major trauma.

Exclusion Criteria:

1. Unable to provide informed consent (dementia, limited decision making capacity)

2. Admitted by medical service for significant co-morbidities

3. Retained hardware around the affected hip

4. Infection around the affected hip

5. Transfer patients with a length of stay > 24 hours at the transferring hospital

6. Known allergy to acetaminophen

7. Current use of narcotics

8. Receiving a regional anesthetic block at any point during the hospitalization

9. Known history of hepatic disease (hepatitis, cirrhosis)

10. Weight < 50kg

11. Prisoner

12. Involved in another clinical trial that would interfere with the intervention of this
study
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Grand Rapids, Michigan 49503
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