Intravenous Paracetamol Infusion Research Articles

Challenges in Assessing Blood Pressure in Adults Following Intravenous Paracetamol Infusion in the Emergency Room.

Background and objective The negligible side effects of paracetamol along with its ease of availability have catapulted paracetamol to be a widely used medication in emergency room management to reduce pain and subsequent elevations in blood pressure (BP). Our study aimed to address thechallenges in informed clinical decision-making in the emergency room following paracetamol intravenous infusion. Methods This was a retrospective cross-sectional studyinvolving the extraction of data from electronic medical records of patients who received intravenous paracetamol infusion between January 2022 and May 2022. Demographic information and BP-related data were collected for analysis. Results We initially considered a total of 162 patient records, with 132 of them eventually meeting the inclusion criteria. Among patients receiving paracetamol infusion for 15 minutes or less, 34% showed a drop of 1-5 mmHg in systolic BP (SBP), while 26% experienced a drop of 6-10 mmHg. However, infusion time longer than 16 minutes did not significantly reduce SBP. Diastolic BP (DBP) was not significantly affected by theduration of the paracetamol infusion.Analysis of the drop in SBP revealed no significant associations with age, gender, or ethnicity. Mean arterial pressure (MAP) was not significantly affected by theduration of paracetamol infusion. Conclusion Our findings suggest that intravenous paracetamol infusion does not significantly lower BP in adults in the emergency room, except for infusions ofshorter durations. However, various factors, including infusion rate, patient characteristics, and concomitant medications, may influence BP measurements. The study emphasizes the need for establishing standardized criteria and conducting further research to assess intravenous paracetamol's hemodynamic effects accurately.

Intravenous paracetamol infusion and tramadol as agents for post operative pain relief in urosurgical patient: A randomized control trial

Analgesia is one of the most important consideration in perioperative setting as it determines the recovery and discharge of a patient. Among the drugs used for analgesia, non steroidal anti-inflammatory drugs and opioids are the most commonly used ones in the current scenario. The aim of this study was to compare the efficacy of intravenous (IV) paracetamol and IV tramadol in alienating pain postoperatively. 100 adult patients of ASA grade I & II in the age group of 25-55 years were randomized into two groups of 50 patients , scheduled for elective urosurgical procedures and were administered IV paracetamol and IV tramadol 30 minutes before the completion of surgery for postoperative analgesia and assessment was done with visual analog scale (VAS)score. In the present study, both the drugs showed effective pain relief. The onset of analgesia is faster in tramadol group. In paracetamol group, the onset of analgesia was slightly delayed but pain scores significantly decreased after 60 min, and this was observed up to 6 h with a statistically significant decrease in post operative nausea vomiting( PONV )with paracetamol group .

The effect of intravenous paracetamol infusion on postoperative nausea-vomiting and pain following strabismus surgery in children- a randomised controlled trial

The effect of intravenous paracetamol infusion on postoperative nausea-vomiting and pain following strabismus surgery in children- a randomised controlled trial

Safety of rapid intravenous paracetamol infusion in paediatric patients

PurposeParacetamol is recommended as a first-line treatment for pain and fever in paediatric patients. Intravenous (IV) infusions are recommended to be administered as a 15-min infusion to minimize local tissue trauma and related pain. The purpose of this study was to demonstrate that IV paracetamol could be administered during 5 ​min or less in paediatric patients without causing related adverse reactions. MethodsProspective, observational safety study including children aged <18 years who received IV paracetamol. Pain scores before and after the paracetamol infusions were obtained using VAS, FLACC, COMFORT neo, or COMFORT behaviour scales with scores from 0 to 10 representing no pain to worst pain. Further, objective signs of inflammation at the infusion site were registered. FindingsWe included 44 patients (median age 2.8 years, range 0.01–17.0 years) who received paracetamol in a peripheral venous catheter (n ​= ​22) or central venous catheter (n ​= ​22). In total, the 93 paracetamol infusions had a median infusion time of 3:00 ​min, range 0:40 to 5:00 ​min. After infusions, pain scores were lower, compared to before infusions (mean change −0.26, 95% confidence interval −0.45 to −0.07, P ​= ​0.007), and no objective signs of inflammation were reported. ImplicationsThis safety study indicates that IV paracetamol can be administered in paediatric patients with a shorter infusion time than recommended without causing adverse reactions. The results may contribute to a more efficient workflow at paediatric departments.

Efficacy of intravenous paracetamol infusion for prolongation of analgesia under spinal anesthesia for myomectomy

Objective: To assess the effectiveness of intravenous (iv) paracetamol (PCM) infusion in prolonging the duration of analgesia following spinal anesthesia and to determine patients’ satisfaction with pain relief. Materials and Methods: This was a double-blind, randomized, controlled study. A total of 126 adult American Society of Anesthesiologists physical status I or II women scheduled for elective myomectomy under spinal anesthesia were enrolled in the study. Patients were randomly allocated into two groups. PCM group (group A) [n = 63] received 100mL of 1g PCM and Normal saline group (group B) [n = 63] received 100mL of normal saline after spinal anesthesia was established. Statistical analysis was done using Statistical Package for Social Sciences, version 17. Results: There was no statistical difference between the groups in terms of age, weight, and body mass index. The mean time to first analgesic demand was 4.75 ± 1.59 h in group A and 2.23 ± 0.15 h in group B (P < 0.001), while the mean dose of additional analgesic was significantly lower in group A (11.81 ± 2.50 µg) when compared to group B (255.49 ± 140.80 µg), P < 0.001. In group A, 75.8% expressed excellent satisfaction with pain relief while 62.9% of patient in group B reported poor satisfaction with pain relief (χ2 = 87.600, P < 0.001). Conclusion: Intravenous infusion of 1g PCM is effective in prolonging the duration of analgesia following spinal anesthesia for myomectomy.

Comparative Study of Intravenous Paracetamol Infusion versus Intramuscular Tramadol as an Intrapartum Labor Analgesia

Context: Paracetamol exerts its analgesic effect by inhibiting prostaglandin synthesis in the central nervous system and peripheral action by blocking the generation of pain impulses. It has also a serotonergic (5Ht) mechanism and a cannabinoid agonist mechanism. Aims: We planned this study to compare intravenous and intramuscular tramadol as labor analgesia. Settings and Design: This prospective single-blinded randomized study was conducted in primigravida labor patients at tertiary care hospital between January 2016 and December 2018 after getting the permission of the ethical committee. Methods: Patients were randomly divided into two groups using a computer-generated random table in the Paracetamol group (Group A) and Tramadol group (Group B). Group A (60 patients) received IV PCM 1000 mg in the active phase of labor single dose over 15 min. Group B, received intramuscular tramadol hydrochloride 100 mg. Labor was monitored using partograph, pain intensity was recorded before, 1 h, and 3 h of drug administration using the Mac Gill pain intensity scale. Statistical Analysis Used: We did statistical analysis using IBM SPSS version 22.0 software. We used an independent t-test to analyze the difference in continuous dependent variables in two groups. The MacGill's pain intensity scale score was examined using repeated measures of analysis of variance for mean scores on 3 outcome measures: Before drug delivery, 1 h after drug delivery and 3 h after drug delivery. Results: Overall paracetamol was well tolerated as compared to tramadol. Patients who received paracetamol experienced fewer side effects including nausea and vomiting. The difference was statistically significant (Chi-square = 8.091; df = 2; P = 0.018). In the paracetamol group, 8 (15%) patients had nausea and 1 (2%) experienced vomiting; while in the tramadol group, 6 (11%) patients had nausea and 10 (19%) patients experienced vomiting. Conclusions: Paracetamol is safe labor analgesic as compared to intramuscular tramadol. Further studies consisting of a greater number of patients are needed to validate the results of this study.

Parecoxib Vs Paracetamol for Treatment of Acute Renal Colic Due to Ureteric Calculi: A Randomized Controlled Trial

To compare efficacy and safety of parecoxib and paracetamol for treatment of acute renal colic due to ureteric stones. A randomized, double blinded, controlled trial included adult patients presented to emergency department with acute renal colic due to ureteric calculi between June 2019 and August 2020. Patients with hypersensitivity to either drug, peptic ulcer, coronary ischemia, peripheral vascular or cerebrovascular disease, hepatic impairment (Child-Pugh score >10) or chronic kidney disease stage 4 or 5 were excluded. Eligible patients were randomized to group 1 who received 1g intravenous Paracetamol infusion or group 2 who received 40mg intravenous Parecoxib infusion. Pain analogue score was evaluated before treatment and 30 minutes afterwards. The primary endpoint was the need for rescue analgesia for persistent pain. Safety was evaluated by the incidence of adverse events. The study included 203 patients (102 in group 1 and 101 in group 2). Pretreatment patients' data were comparable for both groups. The mean pain analogue score decrease from 7.6 to 3.8 in paracetamol group (P <.001) and from 7.8 to 3.4 in parecoxib group (P <.001). Rescue analgesia were needed in 36 patients (35.3%) in paracetamol group and 27 patients (26.7%) in parecoxib group (P=.187). Minor adverse events developed in 2 patients (2%) in paracetamol group and 3 patients (3%) in parecoxib group (P=0.683). Paracetamol and Parecoxib were effective for treatment for patient with acute renal colic. Both treatments showed comparable results in reduction of pain and need for rescue analgesia with minimal adverse events.

Efficacy of Intravenous Paracetamol Infusion Versus Intramuscular Tramadol as an Intrapartum Labour Analgesia

Background: Various studies have debated intravenous paracetamol as analgesic agent However, there are no significant trials regarding comparison of paracetamol with other agents like Tramadol regarding analgesic effect on labor pain. Objective: To compare the efficacy of intravenous paracetamol infusion versus intramuscular tramadol as an intrapartum labour analgesia. Methodology: In this quasi experimental study, a total of 110 women with active phase of labour of term pregnancy, 18 to 40 years of age, were included. Duration and setting: May to November, 2019 at Department of Obstetrics and Gynaecology, Shaikh Zayed Hospital Rahim Yar Khan. In Group A, single 100 ml intravenous infusion containing 1000 mg of paracetamol while in Group B patients, tramadol hydrochloride 100 mg intramuscular, was given. All patients in both groups were evaluated by visual analogue scale and efficacy (yes/no) was noted. SPSS 20 was used for data analysis. Results: The mean age of women in group A was 27.73 ± 5.35 years and in group B was 27.36 ± 5.61 years. The mean gestational age in group A was 39 ± 1.53 weeks and in group B was 38.95 ± 1.56 weeks. Parity was from 0 to 5 with mean parity of 2.46 ± 1.17. Efficacy (in terms of VAS score 0-3) was seen in 21 (38.18%) in group A (intravenous paracetamol infusion) and 09 (16.36%) in group B (intramuscular tramadol) with p-value of 0.010. Conclusion: This study concluded that efficacy of intravenous paracetamol infusion is better than intramuscular tramadol as an intrapartum labour analgesia.

Comparative study between intravenous paracetamol infusion versus intramuscular tramadol as intrapartum labor analgesic

Comparative study between intravenous paracetamol infusion versus intramuscular tramadol as intrapartum labor analgesic

Effect of intraperitoneal bupivacaine on postoperative pain in laparoscopic bariatric surgeries.

Postoperative pain has many adverse effects and, if not properly controlled, it may lead to a wide range of complications. Opioids, as frequently used drugs for pain control, have some serious respiratory and gastrointestinal complications, especially in obese patients. In this study, we planned to evaluate the effect of intraperitoneal bupivacaine lavage on postoperative pain in laparoscopic bariatric surgeries. The study was conducted in Firoozgar Hospital (affiliated to Iran University of Medical Sciences), Tehran, Iran. In this clinical trial, 106 patients scheduled for laparoscopic bariatric surgery, randomly assigned to receive either intraperitoneal lavage with 50 mL of .2% bupivacaine or the same volume of normal saline during the operation. One-gram intravenous paracetamol was infused for all patients at the end of surgery, and all patients received intravenous paracetamol infusion for 1 day after surgery. Pain level, assessed by visual analog scale, was recorded at 1, 4, 8, and 24 hours after surgery. Total additive analgesics administered during the first day after surgery was also recorded. The pain score during the first 24 hours after surgery decreased significantly in both groups, but comparing the groups showed that pain level at 1, 4, 8, and 24 hours after surgery in the bupivacaine group was significantly lower than the normal saline group (P < .05). Also, opioid consumption during 24 hours was significantly lower in the bupivacaine group (P < .001). Intraperitoneal lavage with bupivacaine is an effective approach to control postoperative pain in obese patients undergoing laparoscopic bariatric surgery.

Efficacy of Intravenous Paracetamol Infusion for Attenuation of Hemodynamic Responses to Laryngoscopy and Tracheal Intubation

Background and Aim: Pressor response in relation to laryngoscope and tracheal intubation generally lead to rise in heart rate and blood pressure. This response needs to be controlled. The aim is to study efficacy of intravenous paracetamol infusion given before induction to control hemodynamic response at laryngoscopy and endotracheal intubation. Materials and Methods: It was prospective randomized study, after institution ethical committee clearance, Sixty patients of American society of Anaesthesiology class I and II undergoing elective surgery under general anaesthesia were selected and divided into two groups each comprising 30 patients.Group P received inj. Paracetamol -20mg/kg 30 min before induction and Group F received inj. Fentanyl 1mcg/kg before induction. The primary objective was to observe hemodynamic response at intubation and 1,3,5,10 min after intubation. The secondary objective was to measure rate pressure product and any side effects associated with drug. Results: There was no demographic difference found between two groups. Both the group showed decreased hemodynamic response, but it was highly significant with inj.fentanyl. Conclusion: IV Paracetamol administration 30 minutes before induction does attenuate hemodynamic response but not as significant as with inj. Fentanyl. Keywords: Endotracheal Intubation, Fentanyl, Laryngoscopy, Paracetamol

A Randomized controlled trial of intramuscular pentazocine compared to intravenous paracetamol for pain relief in labor at Aminu Kano Teaching Hospital, Kano

Background : Labor is generally considered to be a very painful experience. Epidural analgesia which is the gold standard for labor pain relief is not widely available, affordable, or feasible, especially in our environment. Parenteral opioid analgesics, which are more commonly used, can cause nausea and vomiting in the patient and respiratory depression in the neonate; hence, they cannot be used in all stages of labor. There is thus the need for an alternative analgesic with similar or superior analgesic effect to opioids but without their fetomaternal side effects. Objectives : The objective of this study was to compare the efficacy of intramuscular (IM) pentazocine and intravenous (IV) paracetamol infusion in relieving labor pain at Aminu Kano Teaching Hospital, Kano. Study Design : It was a randomized controlled study. Methodology : One hundred women with singleton uncomplicated pregnancies and spontaneous labor at term were randomly assigned to the study group or control group. Women in the study group received an IV infusion of 1000 mg of paracetamol while women in the control group received a single dose of 30 mg of pentazocine intramuscularly. Labor pain perception was assessed using visual analog scale (VAS) scores at presentation and after delivery while maternal satisfaction assessed using Likert scale, and maternal and fetal complications were recorded after delivery. Statistical analysis was done using computer software SPSS Version 20.0. Chi‑square, Fisher’s exact test, t‑test, and Mann–Whitney U‑tests were used to compare means and proportions as appropriate for statistically significant differences, setting the level of significance (P value) at <0.05. Results : There were no statistically significant differences between the two groups in their sociodemographic characteristics, obstetric characteristics, and labor characteristics. There was also no statistically significant difference in the VAS pain scores between the two groups before administration of the analgesics (P = 0.968) and after administration of the analgesics (P = 0.225). The maternal satisfaction with pain relief among the patients in the two groups was also found to be similar (P = 0.341). Nausea (P = 0.002), vomiting (P = 0.012), and drowsiness (P < 0.001) were significantly higher in the pentazocine group when compared with the paracetamol group. None of the patients in the two groups developed dyspnea during labor, skin rashes, or persistently low systolic blood pressure of <90 mmHg, and none had persistent fetal heart rate abnormalities during labor or appearance, pulse, grimace, activity, and respiration (APGAR) scrores <7 at the 1st or 5th min after delivery. However, the mean APGAR score of the neonates at 1 min was significantly higher in the paracetamol group (P = 0.033), while there was no difference in the mean APGAR scores of the neonates in the two groups at 5 min after delivery (P = 0.152). Conclusion : The analgesic efficacy of IV paracetamol was similar to that of IM pentazocine in labor, with similar levels of maternal satisfaction with pain relief, but IV paracetamol was associated with significantly lower rates of adverse effects. Key words : Labor; pain relief; paracetamol; pentazocine.

Efficacy of Paracetamol Versus Tramadol Plus Ketorolac for Pain Control after Hemorrhoidectomy: A Prospective Randomized Trial

nbsp nbsp nbsp Objectives Postoperative pain after hemorrhoidectomy is the most feared complication that may result in severe patient discomfort and in a delayed return to daily activities nbsp nbsp nbsp Methods In a prospective randomized controlled clinical trial consecutive patients pts with grades III and IV hemorrhoids were enrolled All pts who underwent conventional Milligan Morgan hemorrhoidectomy were randomly assigned to receive either mg intravenous iv paracetamol infusion times daily group I pts or iv constant infusion pump of tramadol plus ketorolac group II patients Pain was evaluated using a visual analogue scale VAS at and h postoperatively Length of hospital stay and severe complications were recorded nbsp nbsp nbsp Results The two groups were homogeneous with respect to sex age and degree of hemorrhoidal disease No pain was recorded after h in both groups due to persistence of the analgesic effect of the spinal anesthesia Group II had a significant reduction in VAS scores at h compared to group I p lt At h pts in group II vs pts in group I were discharged p There were two cases of bleeding requiring surgery in group I nbsp nbsp nbsp Conclusion Pain after hemorrhoidectomy is more likely to be controlled by constant infusion pump of tramadol plus ketorolac than by interspersed infusion of paracetamol A better pain control is associated with a shorter hospital stay nbsp

The Effect of Administration of Ketamine and Paracetamol Versus Paracetamol Singly on Postoperative Pain, Nausea and Vomiting After Pediatric Adenotonsillectomy.

Background:Tonsillectomy is one of the most common surgeries in children and posttonsillectomy pain and agitation management is a great challenge for anesthesiologists.Objectives:The aim of this study was to compare the efficacy of a single dose of ketamine combined with paracetamol with paracetamol alone in the management of postoperative pain in tonsillectomy.Materials and Methods:In this study, the subjects were randomly allocated into the two groups: the ketamine and control. Intravenous paracetamol infusion (15 mg/kg) was started 15 minutes before the end of surgery in both groups, continued with the IV injection of ketamine (0.25 mg/kg) in the ketamine group and an equal volume of saline in the control group. Using the children’s hospital of eastern Ontario (CHEOPS) pain scale, pain and agitation score and also the incidence of nausea and vomiting after the surgery were recorded in 0.5, 6 and 12 hours after the operation. Data were analyzed using SPSS software version 16 and P value less than 0.05 was considered as statistically significant in all cases.Results:There was no significant difference between the two groups considering demographic data (age, sex distribution, weight and height). The CHEOPS pain scales were significantly lower in the ketamine group compared to the control group at 0.5 and 6 hours after the surgery (P = 0.003 and P = 0.023, respectively). There was no significant difference in the CHEOPS scale at 12 hours after the surgery, dose of adjuvant analgesic and the incidence of nausea and vomiting after the surgery between the two groups.Conclusions:According to the results of the current study, postoperative analgesia in children was improved in the ketamine group. Therefore, for better management of posttonsillectomy pain, low-dose ketamine administration with paracetamol is recommended.

Comparison between caudal levobupivacaine versus levobupivacaine–nalbuphine for postoperative analgesia in children undergoing hernia repair: A randomized controlled double blind study

ObjectivesCaudal analgesia is widely used in children; the aim of this trial was to evaluate the efficacy of adding nalbuphine to local anesthetic in pediatric patients undergoing hernia repair.Patients and methodsThis randomized double-blind controlled trial was done in department of anesthesia, Cairo University hospitals, and 40 patients with ASA physical status classification I–II, aged 2–7 years were enrolled in this study and randomly assigned into 2 groups; group L received caudal levobupivacaine 1 ml/kg with concentration of 0.25% and group LN received caudal 0.125% levobupivacaine with volume of 1 ml/kg plus 0.2 mg/kg nalbuphine. Pain was evaluated immediately after emergence (FLACC 0 h), after 1 h in the PACU, after 2, 3, 4, 5, 6 and 12 h by the FLACC pain score (Face, Leg, Activity, Crying, Consolability). First time of rescue analgesic, total dose of rescue analgesic and side effects were observed for 12 h.ResultsFLACC pain scores were much less in LN group compared to L group (p value < 0.001) after the second hour. The first time for postoperative analgesic requirement was significantly longer in LN group (384 ± 23.1 min) compared to L group (202.20 ± 23.42 min) (p value > 0.001). The total dose of postoperative supplementary analgesia (intravenous paracetamol infusion) in the first 12 h was significantly lower in LN group (200.5 ± 65.5 mg) in comparison with L group (355.25 ± 69.9 mg) (P < 0.05).ConclusionsCombining caudal anesthesia using levobupivacaine and nalbuphine provided prolonged time of analgesia with no reported side effects.

A comparative study of a combination of paracetamol infusion (perfalgan) and intramuscular diclofenac versus intravenous pethidine, in the management of post caesarean pain

There is growing increase in the rate of caesarean section delivery. Opioid analgesic use, one of the corner stone options is limited by the development of adverse effects. This study evaluated the efficacy of a multimodal method of pain management with or without opioid analgesic. Sixty four pregnant women scheduled for elective caesarean section under spinal anesthesia, were randomized to two groups of 32 subjects each. Group PD received 1gm of intravenous paracetamol infusion and 75mg of intramuscular diclofenac while group P received 50mg of IV pethidine at the end of surgery. Both groups also had wound infiltration with 20mls of 0.1% plain bupivacaine (20mg) after skin closure. The proportion of patients who had VAS of d"3 at various time intervals, time to first analgesic request, patient's satisfaction and side effects/ wound break down were compared. There was no statistical difference between the proportions of patients that were pain free at various time intervals over a period of 24 hours post- operatively, the time to first analgesic request between the groups was not statistically significant. The duration was 242±2.1minutes for the PD group and 181.7±22.1minutes for P group. (P value=0.28). Higher incidences of side effects were observed in the P group with no statistical differences. Patients' satisfaction was better in the PD group compared to the P group. The study demonstrates that a combination of paracetamol infusion and intramuscular diclofenac has similar analgesic efficacy as intravenous pethidine. This combination can be a good substitute for pethidine.

Intravenous paracetamol infusion versus intramuscular tramadol as an intrapartum labor analgesic.

To compare intravenous paracetamol and intramuscular tramadol as labor analgesics. This prospective-randomized study conducted in 200 primigravidae in active labor, distributed into two groups of 100 women each with one receiving intravenous 1,000mg Paracetamol and other 100mg intramuscular tramadol. Pain intensity is recorded by McGills scale before, one and 3h after drug administration. Perinatal outcome is recorded. No difference in pain intensity is seen before drug administration. After 1h of drug administration, in paracetamol group, 4% women had horrible pain, and 29% had distressing pain, while in tramadol group, 30% women had horrible pain, and 60% had distressing pain. After 3h of drug administration, in paracetamol group, 26% had distressing pain, while in tramadol group, 51% women had horrible pain, and 35% had distressing pain. Labor duration in paracetamol and tramadol group was 4.3 and 5.9h, respectively. In paracetamol group, nausea is seen in 2.2% and vomiting in 1.1%, while in tramadol group, nausea is seen in 6.4% and vomiting in 4.3%. Intravenous paracetamol is more effective labor analgesic with fewer maternal adverse effects and shortens labor as compared to intramuscular tramadol.

Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery.

Background:Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv) paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery.Materials and Methods:From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F) and (P) Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS) and amount of fentanyl were measured for postoperative pain assessment (24 h).Results and Statistical analysis:The mean VAS score in 1st, 2nd postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU) and hospital stay which was also statistically significant.Conclusion:The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.

Effect of Paracetamol Intravenous Infusion on Duration and Quality of Spinal Blockade in Patients Undergoing Major Gynaecological Surgeries: A Prospective, Randomised, Double-Blinded, Placebo-Controlled Study

Effect of Paracetamol Intravenous Infusion on Duration and Quality of Spinal Blockade in Patients Undergoing Major Gynaecological Surgeries: A Prospective, Randomised, Double-Blinded, Placebo-Controlled Study Effective pain management is an important component of post-surgical care. For pain relief after major gynecological surgeries, particular attention has been paid to NSAIDs and paracetamol. Paracetamol (acetaminophen) is one of the most commonly used antipyretic analgesics for the symptomatic treatment of acute pain and fever. This study was conducted with the primary aim of evaluating the effect of intravenous paracetamol infusion on the onset and duration of sensory-motor blockade in patients undergoing elective major gynecological surgeries under spinal anesthesia.

The role of intravenous paracetamol in conscious sedation during Internal Cardioverter Defibrillator (ICD) insertion in geriatric patients

BackgroundInsertion of Internal Cardioverter Defibrillator in high risk cardiac patients can be performed by many anesthetic techniques including local anesthesia with moderate sedation or general anesthesia. Many studies have proved that intravenous paracetamol infusion is effective in reducing narcotic requirements in many surgical procedures.PurposeThe aim of this study was to assess the effect of paracetamol in reducing pain as well as apnea and upper airway obstruction during conscious sedation for Internal Cardioverter Defibrillator placement.Patients and methodsIn this prospective, randomized study, 100 patients undergoing elective transvenous placement of Internal Cardioverter Defibrillator (ICD) were enrolled in this study. Pain, respiratory events as apnea and airway obstruction in patients receiving intravenous paracetamol infusion 1 g over 30 min have been compared with those receiving fentanyl in a total dose of 1.5 μg/kg.ResultsThe incidence of airway obstruction was lower in the paracetamol group than in the fentanyl one (P < 0.05). There was also a significant difference between the two groups as regards arterial carbon dioxide tension (PCO2), which was significantly higher in Group F (48.9 ± 0.63) in comparison to Group P (45.6 ± 0.64) (P < 0.001) as well as the degree of sedation where the sedation score was 2.2 ± 0.3 in group P. Also, the Visual Analog Scale (VAS) was significantly lower in Group P than in Group F (P < 0.05).ConclusionIntravenous paracetamol infusion was effective in reducing pain as well as the incidence of intraoperative respiratory events as upper airway obstruction in high risk cardiac patients undergoing Internal Cardioverter Defibrillator insertion.