{"id":4687,"date":"2025-05-06T16:02:56","date_gmt":"2025-05-06T08:02:56","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/cosm\/?post_type=stories&#038;p=4687"},"modified":"2025-07-15T11:19:15","modified_gmt":"2025-07-15T03:19:15","slug":"intravenous-paracetamol-overhaul","status":"publish","type":"stories","link":"https:\/\/medicine.nus.edu.sg\/cosm\/stories\/intravenous-paracetamol-overhaul\/","title":{"rendered":"Intravenous Paracetamol Overhaul"},"content":{"rendered":"\n\n\t\t\t<img decoding=\"async\" loading='false' src=\"https:\/\/medicine.nus.edu.sg\/cosm\/wp-content\/uploads\/sites\/34\/2025\/05\/Untitled-design-13.png\" alt=\"\" \/>\t\t\t\n\t\t\t\t<h2>Intravenous Paracetamol Overhaul<\/h2>\t\t\t\n\t<h5>As Singapore advances towards its net zero ambitions, clinicians like Dr Jo-Anne Yeo are leading the way.\u00a0 At Changi General Hospital (CGH), Dr Yeo and her team spearheaded a quiet but transformative shift: replacing intravenous (IV) paracetamol with oral paracetamol in elective surgeries. The result? A substantial reduction in carbon emissions, significant cost savings, and the preservation of high-quality patient care.<\/h5>\n\t<iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/WkZ0JWynF1o?si=H6Hzts9f4g0qHn9d\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<h1>\n\t\tThe Challenge\n\t<\/h1>\n\t<p>IV paracetamol is widely used in elective surgeries for its perceived faster onset, ease of administration and presumed reliability over oral alternatives. But it also comes with a hidden environmental cost &#8211; nearly 10 times the carbon footprint of its oral counterpart. It&#8217;s also significantly more expensive and generates large amounts of plastic waste.\u00a0\u00a0<\/p>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/cosm\/wp-content\/uploads\/sites\/34\/2025\/05\/Untitled-design-15.png\" alt=\"Untitled design (15)\" itemprop=\"image\" height=\"533\" width=\"800\" title=\"Untitled design (15)\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/cosm\/wp-content\/uploads\/sites\/34\/2025\/05\/Untitled-design-26.png\" alt=\"Untitled design (26)\" itemprop=\"image\" height=\"533\" width=\"800\" title=\"Untitled design (26)\" onerror=\"this.style.display='none'\"  \/>\n<h1>\n\t\tThe Approach\n\t<\/h1>\n\t<p>In October 2018, Dr Yeo introduced a new care pathway at CGH. Patients would receive1g of oral paracetamol\u00a0 in the Pre-Anaesthetic Clinic, with 100ml of water 30-60 minutes before elective surgery, rather than IV paracetamol in the operating theatre.<\/p>\n<p>To ensure patient safety and seamless adoption, anaesthesia staff and pre-anaesthetic clinic nurses were trained on a standardized protocol and additional safety measures were implemented to ensure accurate prescribing, proper administration, and error prevention.<\/p>\n<h1>\n\t\tThe Impact\n\t<\/h1>\n\t<p>Between 2017 and 2022, CGH reduced its carbon emissions by nearly 3,000 kg CO\u2082e by shifting from IVintravenous to oral paracetamol for elective surgeries. That&#8217;s equivalent to eliminating around 3,000 plastic bottles of IV paracetamol each year.<\/p>\n<p>The change was integrated into the care pathway for all adult elective surgical patients, except those with specific medical conditions or allergies, reaching the vast majority of the hospital&#8217;s 15,000 surgeries annually.<\/p>\n<p>In addition to its environmental benefits, the switch led to over fourfold cost savings, with paracetamol expenditure dropping from $1,803 to $424 per 1,000 cases &#8211; all while maintaining patient safety and care quality.\u00a0\u00a0<\/p>\n<h1>\n\t\tDo you have a similar story to share?\n\t<\/h1>\n\t<p>Share your experience. Inspire others. Help shape what sustainable medicine looks like.<\/p>\n\t\t\t<a href=\"mailto:cosm@nus.edu.sg\" target=\"_self\">\n\t\t\t\t\t\tEmail us\n\t\t\t\t\t<\/a>\n\t\t\t<a href=\"https:\/\/docs.google.com\/forms\/d\/e\/1FAIpQLSdEa8p6PT8VzjaEkGiwnD3dMJZX2tZGo_8ITYLvQhoOkHSWxw\/viewform\" target=\"_self\">\n\t\t\t\t\t\tSubmit your #SustainableHealthStorie\n\t\t\t\t\t<\/a>\n<h1>\n\t\tFor more information\n\t<\/h1>\n\t<p>Jo-Anne Yeo, Michelle B.H. Tan, Ee Teng Ong, Adrian Wong, Xuan Han Koh, Avinash Gobindram, <strong><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0007091224004094\">Reducing costs and carbon footprint for preoperative oral paracetamol: implementation of a standardised pathway<\/a><\/strong>, British Journal of Anaesthesia, 2024<\/p>\n<h1>\n\t\tAcknowledgements\n\t<\/h1>\n\t<p>The Centre for Sustainable Medicine would like to thank Dr Yeo, Dr Gobindram, Nurse Hanwar, and the whole medical team for leading the implementation, as well as to the Communications team at Changi General Hospital for their invaluable support.<\/p>\n\n","protected":false},"excerpt":{"rendered":"<p>Intravenous Paracetamol Overhaul As Singapore advances towards its net zero ambitions, clinicians like Dr Jo-Anne Yeo are leading the way.\u00a0 At Changi General Hospital (CGH), Dr Yeo and her team spearheaded a quiet but transformative shift: replacing intravenous (IV) paracetamol with oral paracetamol in elective surgeries. The result? A substantial reduction in carbon emissions, significant [&hellip;]<\/p>\n","protected":false},"featured_media":4693,"menu_order":0,"template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"tags":[],"story-category":[],"class_list":["post-4687","stories","type-stories","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Intravenous Paracetamol Overhaul - Centre for Sustainable Medicine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/cosm\/stories\/intravenous-paracetamol-overhaul\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Intravenous Paracetamol Overhaul - Centre for Sustainable Medicine\" \/>\n<meta property=\"og:description\" content=\"Intravenous Paracetamol Overhaul As Singapore advances towards its net zero ambitions, clinicians like Dr Jo-Anne Yeo are leading the way.\u00a0 At Changi General Hospital (CGH), Dr Yeo and her team spearheaded a quiet but transformative shift: replacing intravenous (IV) paracetamol with oral paracetamol in elective surgeries. 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