the effects of intravenous acetaminophen on pain and clinical findings of patients with acute appendicitis; a randomized clinical trial

o bjective: to determine the effects of intravenous acetaminophen (apotel®)  on pain severity and clinical findings of peritonitis in patients with acute appendicitis. m e thods: this randomized  cross-over clinical trial was carried out duringa 6-month  period from august 2012 to february 2013 and comprised 107 patients diagnosed with acute appendicitis. patients were randomly assigned to received placebo (n=) or apotel® (n=). patients were evaluated before, 30 minutes, 1 hour and 4 hours after administration  of apotel®  or placebo,and were told to fill in two forms. the first form required patientsto measure their painintensityaccording to visual analogue scale (vas). the second form was filled by a surgeon who examined the patients and recorded his or her findings using alvarado score criteria for diagnosis of acute appendicitis at foregoing time points. r esults: of 72 patients, 37 (51.4%) were men and 35 (48.6%) were women. the mean age of the patients was 34.1±13.5 years. the mean pain score in 107 patients included in this study was 7.96±2.3. those who received apotel®  had significantly lower pain scores when compared to placebo at 30 minutes ( p <0.001), 1 hour ( p <0.001) and 4 hours of administration. there was no significant difference between two study groups regarding the frequency of alvarado score; however the frequency of fever was significantly lower in those who received apotel® ( p <0.001). we found that apotel® was not associated with resolved physical findings of acute appendicitis in different time intervals. c o nclusion: apotel® does not affect the clinical findings of acute appendicitis and dos not interfere with the accurate diagnosis. therefore, it could safely be used as a reliable pain relieving agent, in patients with acute appendicitis.