Abstract
Introduction: Though the development of minimally invasive surgery has revolutionized the field of surgery, post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and diclofenac as postoperative analgesia in laparoscopic cholecystectomy.
 Methods:One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II included in this study were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant.
 Results: Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in paracetamol group.
 
 Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect with low mean pain score and less requirement for rescue analgesia compared to diclofenac.
Highlights
Though the development of minimally invasive surgery has revolutionized the field of surgery, postoperative pain is still a significant issue
128 patients were enrolled into the study
On analyzing the demographic data, we found no statistically significant variation in age, sex, American Society of Anesthesiologists (ASA) classification
Summary
Though the development of minimally invasive surgery has revolutionized the field of surgery, postoperative pain is still a significant issue. This study aims to compare the effectiveness of intravenous paracetamol and diclofenac as post-operative analgesia in laparoscopic cholecystectomy. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect with low mean pain score and less requirement for rescue analgesia compared to diclofenac. Patients are more motivated to undergo laparoscopic surgery because of small incision, less blood loss and Submitted: June, 2018 Accepted: October, 2018 Published: November, 2018 a - Lecturer b - Assistant Professor c - Professor and Head d - Department of Anesthesia and Critical Care e - Kathmandu University School of Medical Sciences, Dhulikhel f - Lumbini Medical College Teaching Hospital, Palpa, Nepal. Pain is still the most common complaint after surgery
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
