Preoperative Intravenous Paracetamol Reduces Postoperative Opioid Consumption in Laparoscopic CholecystectomyPatients - An Experience of A Tertiary Specialized Hospital in Bangladesh

Abstract

Background: Afferent blockade of nociceptive (pain) impulses by paracetamol can bein effect throughout intraoperative and postoperative period.Objective: To see the effect of preoperative intravenous paracetamol administration in laparoscopic cholecystectomy patients.Methods: This single blind, randomized, prospective, case-control studywas conducted in Department of Anesthesiology, Square Hospitals, Dhaka, Bangladesh, between July and December of 2014. A total of 60 adult patients scheduled for laparoscopic cholecystectomy under general anesthesiawere enrolled in this study. Patients were randomly allocated equally into two groups – A (cases) and B (controls), through a computerized random table, with 30 patients in each group. Patients of group A (cases) received intravenous paracetamol 10mg/kg (in 100ml of normal saline) 10 minutes before skin incision, while group B (controls) received only 100 ml of normal saline 10 minutes before skin incision. Postoperative pain score, duration of demand of first analgesic after operation and amount of opioid requirement were noted down.Results: The mean age of group A was 39.3±4.3 years and in group B 37.4±4.4 years (P>0.05).The mean pain score after 1 hour of operation was 4.4±0.3 in group A and 4.7±0.3 in group B, which reduced to 2.7±0.3 and 2.9±0.2 after 6 hours, then 1.7±0.2 and 1.8±0.2 after 12 hours and 1.0±0.1 and 1.1±0.2 after 24 hours respectively (P<0.05). Early demand of postoperative analgesic within 10 minutes was observed much less in the group A, compared to group B (P<0.001). The mean amount of pethidine required at 1st hour was 34.8±5.4 mg and 36.6±5.0 mg in group A and group B respectively, which increased up to 77.3±10.7 mg and 92.1±8.5 mg respectively at 6th hour. However, the amount steeply decreased at 12th hour to 29.4±5.4 mg and 28.1±4.7 mg respectively (P<0.001). The total amount of pethidine needed was significantly lower in the group A than that of group B (126.8±14.4 vs. 139.6±9.5 mg; P<0.05).Conclusion: Preoperative load of intravenous paracetamol increases the duration of further analgesic requirement as well as reduces postoperative opioid consumption in laparoscopic cholecystectomy patients.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 246-250